The return home is proving more difficult than I had anticipated. I had expected to be tired, and indeed did settle for a ready made meal on Sunday evening (too tired to check its expiry date – with potentially disastrous consequences!) But I had not anticipated the aftermath of the first physiotherapy session.
Choosing a physio had been problematic as I needed somebody who could see me several times a week and who had a pool – essential for shoulder rehabilitation. There are only two physios with pools, one in le Vigan and one in Ganges. I neither like the le Vigan one – been there before, and anyhow Margaret had confirmed he was full up. So I had booked in with the Ganges one, Monsieur Eymann. He is used by the surgeons in the Ganges clinic and Hans was pleased with his treatment there.
First impressions were good. The cabinet was full of the usual array of physio equipment and an assortment of people pedalling, pulling or swimming away, in other words, the physio is ‘managing’ the treatment for several people at once – not like my usual one-to-one weekly sessions with Joceline, but the price to pay for daily treatment and a pool.
M. Eymann listened attentively to my account of the problems, read the doctor’s report, and did his own authoritative exploratory check of my shoulder movements. He then set me several tasks, involving pulling elastic cords in various directions. He explained that the purpose was to strengthen the deltoid muscle – the only one controlling shoulder movement in a reverse shoulder replacement , as the coiff (collection of muscles) no longer exists. Tackling mobility of the biceps – the muscle which appears to have given me so much pain so far – would not be started yet.
All very fine, and I felt encouraged as I could feel a sense of the deltoid muscle being put to work, but no pain. Until I was leaving the cabinet, when I was almost doubled up with shooting pains everywhere. Luckily I had paid Dorothy, the woman who had just spring cleaned my house for me, to drive me to and from Ganges. She stayed to cook my supper, as I was in no state to do anything.
The pain continued till one in the morning, when it eased off but did not disappear entirely. Back in Ganges again I told M. Eymann this. He started the usual, gentle, movements of my arm – but had to stop immediately as I doubled over with renewed pain. OK he said, the only rééducation possible today was a session in the pool, to release the tightened muscles. And sure enough, after 45 minutes of repeated gentle movements, the pain subsided.
This was the point at which I began to feel anger and despair. I dressed and sat waiting with two others for M. Eymann’s attention. He was rushing between three small rooms where he was evidently treating patients, perhaps with massages, pausing regularly to give the two student physios instructions for their treatment of people on the various machines. It became evident to me that, as with so many of the local physios, he is seriously overbooked. I was supposed to be waiting for my turn on the Tens machine, but it was midday, I had been there for two hours, with no real quality one to one treatment time. Dorothy was waiting for me outside, so I walked out.
Yesterday evening was once again painful, though not as much as Monday evening. This morning I’m much better, though still not able to move as I was at the weekend without my arm hurting. I’m due to go back on Thursday morning. By then I have to decide how to handle my discussion with M. Eymann. It has to work, as I have no alternative options. Realistically I think I will trim down my expected five sessions a week to three. But I want to get out of him some commitment to routine hands on personal treatment, albeit short, plus a plan on how to tackle my rehabilitation now he has seen firsthand how badly the biceps in particular respond to movement.
I am, incidentally, getting more proficient at distinguishing between joint problems ( the ‘blocking’ of movements by the joints following surgery, and the pain in tendons and muscles, in my case primarily the biceps in the arm ut also the deltoid which plays a pivotal role in holding the new shoulder in place.
There is a frustrating lack of images of reverse shoulders (and how the various tendons are connected) on the web. After all, they have only been available for about 20 years. But here are some images of muscles in a standard, non-operated arm and shoulder.
The biceps muscle is joined to the shoulder by two tendons. These were among the many which had to be cut and later resewn in place during surgery. M. Eymann says my problems are rare but, sadly, not the first time he has come across them; he reckons the pain comes from the area where the biceps were sewn back and the scar is causing the pain.