Physical Therapy is working- Shoulder is "thawing out"

Well, with the help of physical therapy three times a week and stretching on my own in between appointments, I am slowly getting range of motion back to my right arm. I am sure the orthopedic doctor who gave me the shot of cortisone will be disappointed at that- assuming I do go back to see him.  What I have found is that the muscles of my shoulder had allowed it to get into a position that stopped it from moving to normal range of motion.  With concentrated effort to move my shoulder prior to stretching, I was able to get it past the previously frozen limits to some extent.  And my Physical Therapist has been getting it to go even further in the manual stretching portion of the treatments.   It is slow progress, but it is working out of it.

Now a frozen shoulder and cortisone inspired hiccups

Towards the end of last summer, I had written about a possible flare. This caused enough shoulder pain that I tended to avoid use of the arm for a while.  I did not really think it had been long enough to cause any problems, but as the first pain subsided a bit, I realized I had lost some range of motion.  I tried to stretch, but by this time it was too late. Now the right shoulder was a bit frozen.

Here are a few things to avoid in the case of future flare-ups. I have to try to remember them myself.

If the pain from a flare is intense enough to cause reduced use, you have to do passive range of motion exercises to keep the shoulder limber from the start.  I am not sure why I forgot about this. It is how I had treated my fingers long ago.

As soon as possible, and as soon as you can stand it, try to do active range of motion exercises.  It may hurt to do so, but it hurts more if you let the shoulder freeze on you like I did.  Now, you may not have the same issues I do. From both MRI's I have had over the years, it has been mentioned that I have a downward sloping Acromial space. This means for me, that the space between the end of the collar bone and scapula is smaller than the norm. This makes me susceptible to impingement disorders. And that may be what I have been dealing with for the last few months.  And, I could have made things better if only I had kept moving.  

Speaking of moving, I have been to a physical therapist recently who actually has treated patients having PTS/NA in the past. I think he really gets it, and I am happy to have been directed to him.

Also, I have been given a shot of cortisone by an orthopedic doctor who really did not get it at all.  I had filled all sort of paper work out explain about my history with PTS/NA.  His first words were, “Well, how did this happen? Were you doing some painting or tree removal?”  Me- No, I really have not been able to do stuff like that. I have Neuralgic Amyotrophy.   Him- “What is that?“    Me- You may know it by its other name, Parsonage Turner Syndrome.   Him-  “Well, that is self limiting and people get better and get immunity to further attacks.”  At this point, I should have run away very fast. Immunity from PTS is nothing I have ever heard of.  I told him of my first two documented cases, and that I know that what started this most recent attack was the same pain in the same part of my shoulder that it has happened the first two times.  The weird thing too is that he is in the same medical group of my original hand doctor who told me I would never recover hand function without surgery.  I told this doctor about that and showed him that my hand was in fact better without surgery.  He then did a short exam and about pulled my arm out of the socket trying to see if I was faking how locked up it was.  Or maybe he thought he could do a quick snap move like a regular chiropractor may have tried.  He also was quick to mention that if I could not get it to free up, that surgery would be needed to fix it.

Surgery.  Hmm. I have not heard much good coming from shoulder surgery.  I am not sure how it would be for me anyway since I am prone to entrapment issues.  Fix it this time, and next time it is going to be worse no doubt.  So, on to the shot.

The shot itself was no big deal.  And it feels like it may be helping me to regain some movement.  I wonder about side effects of cortisone that are not mentioned in the main websites- at least not that I can find.  They mention that it can send your blood sugars through the roof so be sure to tell your doctors that you are diabetic if you are.  It can also make you jittery, as they mentioned at my appointment.  What no one talks about is a possibility that the shot can give you hiccups that can last a couple of days.  For me, I woke up the morning after the shot hicccupping, and it kept up most of the day except for just a few brief breaks.  It seemed totally out of the blue.  A friend asked me if they could be a side effect of the cortisone.  I said, not that I knew about.  But Googling “hiccups after cortisone shots” verified that it happens to many people. And to some who have to take the shot long term, it happens every time they take the shot.  I have no idea why, but I will ask.  Very odd.  I was lucky my own case only lasted the one day.  It was about driving me crazy after a full day of it.

Update: I see on Web-MD that Oral Cortisone is listed with hiccups as a possible side effect.  Not that I had the cortisone orally. . .

Update as I approach 10,000 page views

Hello again, after a bit of an absence.  On the face of it, not much has changed for me really in the last little while.  But, there are subtle differences I am seeing as things go on.

I had what may have been another attack a couple of months ago. It is hard to tell if it was a real attack, or just a continuation of what has been happening all along.  I had a bit of neck and upper shoulder discomfort followed by extreme weakness to my lower back and with some pain in the region of my tailbone.  This went a bit lower actually, into my upper legs, and then seemed to reverse up my back again and ended up with weakness across the bottom edge of scapulas.  I am left now with residual pain at times in my right arm and into shoulder that impacts range of motion, strength of my arm and my ability to sleep comfortably on my right side, just like the old days following my original attack in the shoulder.   Along with this, I have a pronounced weakness in my right calf area (near as I can tell the Gastrocnemius muscle area).

What makes it seem like an attack is the general progression of discomfort and weakness.  But, there was no major pain.  I know from sites and publications that sometimes there is not a lot of pain particularly with HNA, so maybe this is all normal.  

I may remember the initial pain for my shoulder attack.  Did I say this before?  Anyway, in 2002 I had been training for a bike ride.  This was a year or so after my hand and finger issue, so I would still have had a partially paralyzed hand at this time.  The morning of the ride, I woke up and had extreme pain in the area behind my right shoulder blade and could barely hold my head up normally.  That was around 4 years prior to the collapse and eventually winging of the scapulas.  And in a long trip by car in mid 2006, I experienced the first sensations of shakiness that I have now as I repeatedly had to exit and enter the car on this trip across country where I was the only driver.  This trip was just a few months prior to the pain in Oct of 2006 that is linked to my scapular winging beginning.  At the time I assumed this shakiness was due to the long hours of driving daily, but now I know it was an early indication of the onset of the next phase of NA.

It has been a while. . .

Well, I am still here in case anyone has noticed an absence.  Not much has really changed except I am having some pain at times in my right shoulder and neck.  And I am a bit weaker overall.  Yesterday I could barely do one good push-up.  And it was very shaky as always.  I have also noticed slight arm pain in the area between humeral head and shoulder joint, particularly reaching out to pull a door closed as I enter a room.  I have begun to wonder about my breathing too.  I have seen descriptions and videos describing paradoxical breathing,  which can happen in the case of PTS/NA if you have partial paralysis of the diaphragm from phrenic nerve palsy.  


Look here

http://www.youtube.com/watch?v=RFGzdNFuXIM

I do not breathe that way all the time, but I have. Hmm.  Maybe I do more than I am aware.  This is just one more thing to ask a doctor about.

This one is interesting too.

http://www.youtube.com/watch?feature=endscreen&NR=1&v=JeDiS7MWXNk

Seems every muscle group impacting PTS/NA is mentioned here as being an impact on correct breathing.  And it is suggested incorrect breathing can lead to what they call gothic shoulders. Looks to me like winging and a possible “what came first?” scenario.  Those shoulders could be related to what causes the breathing issue more than the breathing issue causing the stooped shoulder posture.  

Short Updates

Well, where am I, you may ask. It has been a while. 

Push-ups:  I still seem to be stuck at being able to do 5, and that is with a lot of shaking. Some things do not ever change.

DHEA: I have started DHEA again at 50 mg a day.  This is a 25 mg tablet twice a day.  Why? Well, I thought I would give it a try since every eye doctor I have asked about it says DHEA had nothing to do with my eye pressure spike of a few years ago.  I see that 50 mg is a suggested daily amount that may be beneficial for aging types, which includes me. So far, I really have noticed a decrease of my fine motor tremor since going to 50 mg a day.  It does not seem to help much on shaking, as noticed on almost anything I do requiring any strength.

Prednisone: There have been a couple of times since the last entry where I have experienced pain in both scapulas, and some pain in my right hand. This was noticed when I made a fist. I took a 10 mg prednisone a day for a few days, and that stopped that. 

Cause and effect or coincidence: I just note what appears to have helped me. Recognize that it all may be coincidental that I notice DHEA helping tremor, since it is not one of the probable benefits as listed in the literature of DHEA. Ditto that for prednisone helping scapula and hand pain. Your mileage may vary.  

Why is the shoulder the most common first complaint in NA

http://www.umcn.nl/Informatiefolders/7130-Neuralgic_Amyotrophy__id-i.pdf 

If you are like me, you may have wondered why it is that the shoulder is the most common first noticed complaint in Neuralgic Amyotrophy attacks. Maybe it never crossed your mind after all.  I figure, if there is a causal agent in the bloodstream, and it finds the shoulder plexus site to attack, it is just as likely to find other nerves at other plexus sites.  It may be clever, but is it really smart enough to be that specific?  If you listen to most doctors, they would suggest “yes”, it is that specific.  If you have any other issues in other areas with weakness, it is either all in your head, or you have something else they can charge thousands of dollars to test for, and come up with nothing.  “Oh well, nothing wrong with you- got to scoot”.   

If you read the document (linked above), there are two things talked about which suggest a reason for the shoulder being the most common joint impacted with NA.  It begins with overall muscle loss, and ends with the efficiency of muscles to do work with impeded nerve connections.  The author first speaks of muscle loss, stating that

“In daily life, people generally do not notice that they are losing muscle strength

until they have lost around 30% of their maximum strength. The strength that lies

between 70% and the maximum of 100% is, as it were, ‘extra’ in case heavy exertion

must unexpectedly be made.”

So, you could have an attack of NA that leaves you with a gradual loss of muscle strength to say 75% of normal, and not even notice it.  I think this actually happened to me, looking back. I had had an attack that impacted my right hand and left my arm weak. But otherwise, I had no clue what was going on, except, on a long car trip, I noticed a bit of shaking at times getting into or out of the car.

Time passed, and one night I woke up on my right side and noticed that my shoulder popped, and collapsed a bit. There was no pain, just the sensation of settling that did not feel normal at all.  Why would this be important? Look to the document again. 

“For most of the muscles, one can say that they function well in daily life

once they have regained 70% of their former strength. However, some muscles

must truly be nearly 100% recovered before they can function normally again.

The muscle that, when it fails, causes a protruding shoulder blade, (the serratus

anterior) is the most important example of this. Because this muscle needs its

maximum strength and endurance in order to work well, it sometimes seems as

if recovery of the nerve to this muscle takes much longer than the recovery of the

other nerves.”

It would seem possible that the muscles surrounding the shoulder are a bit more sensitive to nerve loss than other sites in the body. So that may explain why the shoulder is the first noticed spot that NA impacted, when truly, it is everywhere to some extent.  They go on to say:

“With neuralgic amyotrophy, the strength in the affected muscles is often decreased

to (much) less than 50% of the maximum. It is often not even possible

anymore to carry – or lift – the weight of the arm itself, let alone an extra weight

(for example, a purse or bag). It also becomes difficult to maintain movement or

postures. It is sometimes possible to make a specific movement once (such as

extending the arm or putting something in the cabinet above your head) but it is

not possible to do that a number of times or to keep doing it for a specific period

of time. Both the loss of strength and the difficulty with maintaining movement

are serious impediments for NA patients in their daily work, sports or activities at

home.”

Add to that that any regained strength may be to a lesser amount than what existed prior to the attack. For HNA sufferers, this is augmented by having many more attacks over a lifetime.

Speaking of returning strength. . . Do not do as I did and force it to get better.  Heavy exercise prior to complete healing can lead to further nerve damage and make that nerve even more susceptible to further attacks in the future.

“If, within a nerve bundle, no more than two thirds of the axons are damaged, then

the remaining axons will take over the work of the damaged cables within three

to four months. This mechanism is called: ‘collateral reinnervation’. This repair

mechanism works well because the muscle can then again be completely controlled.

However, this is at the expense of some load endurance. That means that the

muscle can certainly provide maximum strength once but cannot maintain it well

or keep it up for long. In daily life, patients often notice that, after a time, they can,

in principle, carry out all of the movements with the arm, but that the arm becomes

heavy and tired after being used for awhile and they must stop and rest before

they can continue with what they were doing.”

“If the nerve has been affected a number of times, the chance of recovery decreases.

Also, nerves are not able to tolerate everything: If they become even more

damaged, they will be ‘broken’ for good. In practice, this means that the function

of, for example, the arm after an initial period of painful loss of function will still

recover for the most part, but that, after a second or third time, will not recover as

completely and, ultimately, will not be able to recover at all. The loss of strength,

but also the disorders in sensation and blood supply to the skin, then become

permanent.”

Information on hereditary and non-hereditary neuralgic amyotrophy for patients and caregivers

From Wikipedia, we now have access to this document in PDF format that is in the external links secion of the references.  http://en.wikipedia.org/wiki/Hereditary_neuralgic_amyotrophy

[1] Information on hereditary and non-hereditary Neuralgic Amyotrophy for patients and caregivers
http://www.umcn.nl/Informatiefolders/7130-Neuralgic_Amyotrophy__id-i.pdf

By clicking on the blue [1] above, it should take you to one of the more comprehensive overall reviews of Neuralgic Amyotrophy I have seen yet.  Check it out.  It answered a few questions for me.

Strength update

Well, I am back down to 10 pushups and those are a struggle. Also, I attempted to do a bit of yard work yesterday keeping in mind that I have to watch what I try to do. I seemed very shaky during this and that actually helped me to limit what I tried to do. But, I still had problems later; a tender pain area under right scapula and a feeling of weakness (if I can get any more weak) down my right arm. That arm issue seems better today, but I still notice a pain under my right scapula.

Experience Project "I have Parsonage Turner Syndrome"

This could be interesting for anyone wanting to see how others have dealt with PTS. There are not a lot sharing stories of their PTS, but it can give you an idea of what it is like for others. Or, you can join and submit your own story of how PTS impacts your life.

http://www.experienceproject.com/groups/Have-Parsonage-Turner-Syndrome/92246

Timolol and strength update

Well, it has been a bit more than a week since I have stopped the beta blocker eye drops, aka Timolol. The theory is that they may have either caused or exacerbated my tremor and muscle weakness. The timing suggests at least a probable cause enough to be suspicious.

Initially, I felt that my fine motor control was much improved, and the few twitches I have had ongoing appeared to have stopped.

But then I had to go and spoil it all by attempting to do a bit of yard work today.

Trying to lift things is still a problem. But, overall my lower back and upper legs felt much stronger than they have in previous similar outside work. My hands, particularly on the left, still tremor after any exertion. At one point I had my left hand resting on a board trying to hold it steady, and it was shaking quite a lot. I just tried to work through it.

During the work period, I had a few instances of just not knowing how to proceed. I am not good at building things anyway, but this was a fairly simple thing to attempt. I am not sure why things like this seem to happen. I guess there was a symptom for confusion listed in the Timolol. And I also know that can happen for magnesium deficiency. It has got to be the Timolol unless there is still something else at work here other than NA and its associated weirdness.

I got to a point, I just had to quit though. It was not quite done, but I was at a point that going on would have been prone to my making mistakes, and some of those could be dangerous when weakness takes over while using power tools. My shoulders were done. I could feel my scapulas trying to hold my shoulders stable- and it hurt a bit. Now I have trouble reaching my arms out away from my body. I may have over done things.

But I also just did 30 push-ups with only minor shaking towards the end.

A better way for Scapular Pushups

My Physical Therapist originally showed me how to do scapular pushups to help strengthen and stabilize my shoulders. I never felt that it did much the way I was shown. Here is a bit more advanced way to try if you want.

http://www.youtube.com/watch?v=ALzFr2GT-Is

The other shoulder

Off and on recently I have had things going on with what had been my un-impacted left shoulder. I say un-impacted even though my left scapula does show sign of slight winging. What has been happening is that I feel a dull ache from my scapula that feels like it is traveling down my arm to my left thumb. During these times, my arm is about useless even though the pain is not what I would call bad in any way. At least it is not bad compared to what I know it could be.

So, I am not sure what it means, if anything. I have had no pain recently in the left side of my neck. But, I do continue to have left sided headaches periodically, as I have had since this all started in 2006. I know my doctors would just say it is due to overuse. But, what should I do about that?

Magnesium Deficiency and H1N1 shots related to Parsonage Turner Syndrome?

I notice in reports that some have searched to find my blog with these queries. Do not worry, that is all I can see about the site. I do not see any information about any specific users. . .

Anyway, about the queries-

Flu shots a cause for PTS?

I have never seen any evidence specifically linking any particular injection to Parsonage Turner Syndrome. But, I have seen that Brachial Plexus Neuritis (one name PTS can go by) has at least been linked to certain injections, among them influenza injections. Sites I have seen do not say injections are a direct cause, but only that in certain cases, the only thing that had happened recently to a sufferer is that they listed having had a flu shot. See this site for examples of causes- if you have not already found it. http://emedicine.medscape.com/article/315811-overview

Magnesium Deficiency linked to PTS?

Magnesium Deficiency is a possible culprit in many diseases as I have alluded to in the blog previously. It does cause overall weakness, tremors and twitching and a general feeling of malaise- like you are just winding down to minimal function. In my opinion, if you also have PTS or NA, or even HNA, the weakness associated with PTS can be additive if you have magnesium deficiency on top of it. It was for me at least. But, as a cause, I do not think magnesium deficiency would be a direct cause for PTS in any of its other names. PTS causes winging scapula and other distinct muscular losses, and may cause a general weakness of the impacted limbs. But, low magnesium would produce weakness all over the body by comparison. Also, once you correct the magnesium deficiency, overall strength improves quickly, along with a cessation of other related symptoms like twitches and tremors. Even at that though, my scapula is still winged, and my right thumb is still partially paralyzed.

Keep those joints moving!!!

Hello Blog People- You know who you are.

It has been a while since I have written anything substantial. A week or so ago I woke up in the middle of the night and wrote an entry in my head as I lay there trying to fall back asleep. It still has not been written, but it would deal with the importance of KEEPING YOUR IMPACTED JOINTS MOVING.

(DISCLAIMER- I am not a Doctor or a Physical Therapist- Do any exercise program not prescribed by them at your own risk-)

Movement is essential to regaining any of your strength. What good would it be to get back strength if you could not move the joint? Start passive movement of the joint as soon as you can do so without pain. Your Physical Therapist can give you exercises to help. But remember that PTs are just there to remind you of what you should already know about your body. If you do not use it, you will lose it. In order to use it, it has to be able to move. Strength will follow.

A good and easy passive arm motion exercise is to just bend at the waste, and let the impacted arm hang lose towards the floor. Gently swing it using movement of your upper body. Swing it back and forth, or in a circular motion. Maybe go one way for a few turns, and stop and reverse. Do not use your arm muscles in any way to do this. That is the passive part.

Another passive exercise you may be able to do yourself if your good arm is good enough to lift your impacted arm through its range of motion. Or, you can enlist the aid of someone you trust. I say that tongue in cheek a bit, but trust is important in dealing with allowing someone to lift your arm for you and move it through range of motion you may not have. You have to be aware of when and if it is uncomfortable for you, and they have to be aware that you may not react in time to stop them before you reach that point. It is best to do this after being shown by a Physical Therapist, but if you do not live with one, you may have to improvise.

You can also do arm movement on your back on a bed. At that time, your scapula is fairly well supported, and may actually be in its normal position. When I tried to do range of motion on my back in this way, I was pleased to discover I could do a lot more movement than I thought I could do. But still be careful.

Regular readers know that I have used push-ups as a gage of my strength being there, or not. This is not something you should just start out doing on your own, or at least, not full push-ups. My PT suggested to me that I start with scapular push-ups. For these, you get in the standard position, but instead of lowering yourself to the floor, you attempt to just flex and release muscles of your scapula. It is not easy to describe. Here is a You-Tube video (http://www.youtube.com/watch?v=z4G0lSwL2os). It would be better if the guy was shirtless to see if he had the right technique, but it looks OK to me.

Along with those, there are various stretches to try. Stand in a doorway and put your arm up at a 45 degree angle as if you were motioning for someone to stop. With your arm against the door jamb, push through the door enough to slowly stretch your upper arm.

Then there is wall walking. I tell you, the internet has everything. I was going to try to explain this, but here is a link that does it with pictures. http://nih.kramesonline.com/HealthSheets/3,S,89905 Like it says; do not try this unless you have been cleared by a professional. I was cleared fairly early. In fact, I think it may have been too early. It was at least before they knew I had the scapular winging. But, the range of motion and strength I have to lift my arm over my head are because I did this exercise from the beginning.

What if your arm is OK and you have a problem elsewhere? Well, for me, my hand was also impacted a few years earlier. All they told me was that I should keep my tendons flexible. Be creative. Your hand is a lot easier to do passive exercise on. People may look at you funny, but you really have to make it such a habit to keep your fingers moving that you do it without thinking about it. Do a bit of passive, and then try to actually move the fingers that will not move yet. I mixed this a bit, and physically moved the finger with my left hand as I tried to move finger of my right hand on its own. It would also help to have some sort of electric muscle stimulation treatments. At least, it helped me. I was lucky that a Physical Therapist who was interested in my case loaned me a muscle stimulation unit that was surplus for his practice. I used this at least a couple of times a week as my right hand returned to function.

Well, that is not quite how I wrote it in my head, but it will do. Good Luck getting movement back!!!

Strength return – Pushups again

On Oct 3rd or so, I had been able to increase my number of pushups back to around 7. Here it is Oct 18, and I have now been able to do 10 for the last few tries. And I have been giving it a couple of days of rest between attempts. Being able to do 10 again seems a bit disappointing in a way. I know the muscle is capable of doing 25- somehow because it was not all that long ago that I was able to do 25. I find it frustrating that I have to dial down my expectations. But, I also do not want to over fatigue myself and hurt my recovery as I did last time.

On the bright side, my right scapula feels pretty good while doing the pushups. But, my upper arms are still pretty weak and the tremors continue.

Pushup Update

Long term readers (if there are any) may remember the saga of my pushup history. A brief recap is that just after my right scapula started to wing in late 2006, I could still do around 20 or so pushups. A month or so later, that started to decline to the point where I could not do even a single pushup. Since then, the number I can do has varied from around one, to a high of four or barely five. Usually, I could only coax 2-3 out of my body before I would collapse.

There may be hope. Today, I was able to do ten.

Now, this still was not easy. I barely got to the tenth one. But, it was a full ten as low to the floor as I could ever go when I was stronger. One thing I noticed- other than my wrists feeling like they may break before I was done- was that my lower back and upper legs shook like crazy when I was doing them. Shaking may not be the right word. They just felt as if the muscles were firing inconsistently, and pulsing instead of holding steady as they should do. I used to wonder about that happening. Now I know it is due to the NA or HNA impacting nerves in my lower body and legs.

I said there may be reason to hope that this may be improving, but I am not really confident that will happen for me at this point. I am better today: maybe not so much tomorrow. This seems to go in cycles.

One thing it points out to me though is something I have said before. Never give in to this. Just because it seems that a muscle is no longer working, keep trying. If it is not working today, try again in a few more days. You may see a change. You may find a glimmer of hope.

That’s funny, you do not look sick. . .

Related to this, see my link to the right for “Spoon Theory- Funny, you don’t look sick. . . “

You know, one thing about NA/HNA is that because the expression of the symptoms can vary so much, it is hard to really for someone else to see that it is impacting your life. In fact, just to look at me, unless you were a trained health professional, you may not be able to tell I had anything wrong unless I took my shirt off, and you saw my scapula were not right. And even if you were a health professional, you may miss it.

In my previous entry I described how doing relatively easy “work” for an hour impacted me and my arms and hands. That shaking was real to me, and it is really one of the few outward signs that I have of this “disease” that others may be able to see. Yet, even though others may know I have this condition, and they see it manifest in this manner, they still make comments like, “Oh, you are a weekend warrior- I guess you must be a bit out of shape.” Well, yes I am no doubt a bit out of condition right now, but it this shaking is not due to being a weekend warrior in the garden. “Well, look at that, I am out of shape too- See how my hand is shaking too?” Yes. But the difference is that my hand was shaking before I started to work out here, and at this point, I am not sure I will be ever to ever get back into a condition where my hands to not shake. It may be true that your hands shake a bit after doing too much work- but my hands shake all the time. It does not matter if it is picking up a paper cup of coffee at Starbucks, or after working out in the yard for an hour. My hands will shake. In fact, I can wake up in the middle of the night when all I have been doing is sleeping, and if I reach for the covers with my left hand, it will shake.

Well, I can’t complain too much about this. The other person spoken about here does not want me to think of myself as being different than I have ever been. And, I do not want to roll over and let the condition take the rest of my life away by acknowledging that since I started to express certain symptoms, I can’t do this, I can’t do that. Sure, there are certain things that I do not feel comfortable doing now. But, I can still do a lot. It is just that doing some things takes it out of me in a different way than it used to. Doing this job of edging the perimeter of the lawn used to be a job I could do with no problem. Then I would go on and do the next thing, and the next thing, etc. Now, doing the perimeter edging is it for the day. After that, I am done. And if there was a job I got to before I tried the edging, it may be that only part of the edging will be done, or if it is completed, I will be done for a bit longer. I am learning that there are limits to what I can do anymore, and I do not like it. Sure, I am getting older and maybe there would have been age related limits at this point anyway. But, I am getting those too. It doesn’t seem fair.

But, I know there are younger people learning that they have NA/HNA every day. At least I did not develop symptoms until I was in my mid 40’s. I know of a family who has a young child who has had two attacks already, and has bilateral winged scapulas at around age 10. I think of him and realize I really should not complain about my lot. I guess I am lucky I do not have worse going on with my health.

short update

Well, I have not got much of an update at this point. It is interesting to me at least, that in a search for new information I could pass on out here, a search in Google brought up my own blog entries a number of times.

I had been doing pretty well recently as far as staying pain free. That ended last night with a sneeze. This was noteworthy because it popped my left shoulder in the area of my scapula. I do have slight winging on that side, so I am increasingly nervous about any new pain related to my left side in that area. Of course, no good sneeze anymore only jerks one part of my body. For the rest of the night, my neck and upper shoulders on both sides were very sore. I am not suggesting the sneeze as a cause of any ongoing problem, but it sure shows how something so simple can irritate an existing weakness.

Long before I noticed any problem with my right shoulder, I remember waking up on my right side in time to notice a POP in my shoulder that was followed by a noticeable settling. So, who knows? Maybe a sneeze could be the final thing that starts a new attack. I mean, I had been sleeping on my right side like that as long as I can remember, and have had no trouble. But with a slightly weakened shoulder, that pop could have been the start of that attack for me. Sites seem to suggest that exercise can bring on an attack. Maybe something as innocuous as a sneeze or simply sleeping could do it also.

Winged Scapula may need flashing “warning” lights?

I, for at least one, am sensitive about anyone touching my affected right scapula. I am not sure why, or if this is common- but if anyone comes close to touching me, I want to punch them- Well, maybe that is extreme, but at least I want them to stop. It really does make me feel nervous.

Today I was at one of our local home improvement stores- just standing there, and suddenly, I felt something brush past me that bumped my right scapula. I had no idea it stuck out that far that this might be an issue. That is why I am considering getting a flashing light attached somehow. I am joking a bit. Come on everyone- It is called personal space. If you pass by someone close enough to bump their shoulder blade, you are too close. Of course, I guess mine must be an additional inch or two further out than anyone else. That is still too close. Maybe a red flag would do?