Spring New Shoulder Moon
“I’m a doer.” Kate said this yesterday. Yes, she is. So much so that we often referred to her as the energizer bunny. Jon’s divorce, Sjogren’s and arthritis has made doing difficult, often downright painful. The combination put her in a tough place psychologically; but, it feels now, for the first time in a year plus, that she’s going to push through it. As Winston Churchill said, “If you’re going through Hell, keep on going.”
We had her first post-op appointment yesterday and got to see an x-ray of the new appliance. This isn’t hers, but it’s an accurate representation of what we saw. As this image shows, the ball of the shoulder is now where the socket used to be and the socket where the ball used to be. This reverse total shoulder uses different muscles to power the arm, the deltoid in the main. It also reduces pain more for certain patients though I’m not sure why.
Seeing the screws, poking out from the ball, seemed strange to me, but it underscores orthopedics as the carpentry of medicine. Sawbones. The multiple uses of the inclined plane. Thanks, Archimedes.
These surgeries, joint replacement, aren’t perfect, but they’re way better than doing nothing. My knee, for example, is not the knee I had when I was 40, but it is pain free and I can work out without contorting myself. I can’t stand for long periods of time, but I can stand without pain. Kate has two artificial hips and now an artificial shoulder. Pain reduction is a primary benefit of all these procedures and it’s usually pain that leads to them in the first place.
We often talk about folks for whom physical labor is key to their job: trades people, movers, utility workers, lumberjacks, mechanics, farmers, even physicians. Prior to joint replacement as an option, they had to suffer through the pain or stop working. Imagine what it was like on the frontier to have debilitating hip pain, a shoulder that would no longer move above a right angle, a knee that buckled under pressure. Or, in the middle ages, for peasants. Soldiers. Domestic servants.
It’s likely, for example, that Kate’s years of lifting babies and young children led directly to the arthritis that ruined her right shoulder. That’s the Schneider hypothesis since the sort of dysfunction her shoulder displayed is most common in women.
These are life extending surgeries, making it possible to live, rather than exist. I imagine that soon bionics will be more generally available and will complement this sort of procedure, perhaps making up for atrophied muscles which are a common sequelae of joint problems. All this is part of the glass half full view of the future.
