Showing posts with label calcific tendonitis. Show all posts
Showing posts with label calcific tendonitis. Show all posts

Sunday, March 27, 2016

A Setback: Pain, Lethargy, and a Raw Easter Sunday on which Gluttony and Sloth Supplant the Shaddian Will

Stock image of a calcific deposit in a shoulder

The shadow on my x-ray looked very much like this stock image of calcific deposits in a rotator cuff (above). In my case, the shark fin-shaped shadow seemed hazy and vaguely benign yet to a trained professional it symbolized pain, potentially severe, for the unfortunate one in whose shoulder the toothpastey ooze coalesced. In this case, Dubstoevsky's right pectoral fin.



Dubstoevsky as American Shad

What I've learned about this affliction has come from the internet and not from the mime-as-doctor known as Dr. Re (a man whose last name even seems an abbreviation). Perhaps because calcific tendonitis is fairly common in a given population of 30-50 year olds, the affliction must hold no intrigue or interest for Dr. Mime. He's obviously tired of discussing it with patients because at no point did he explain to me that this condition has two possible iterations; reactive (i.e., the body is reacting to something and leaving behind calcium in the rotator cuff; cause unknown); and degenerative (a chronic condition in which the tendons are actually degenerating; thought to be age-related). Nor did he bother explaining that the stage at which the calcium deposits begin to break up (whether spontaneously, which is not uncommon, or from treatment), is the painful part. Seriously painful.


The anatomy rendition

So perhaps waking up Friday morning in surprising discomfort, with the right shoulder throbbing dully but continuously, was a good thing. Perhaps it meant the calcium was starting to go Soviet Union on me and was entering the break apart stage. I sought a silver (not calcific) lining to the pain so seized on the dissolution stage as the likely reason for the intensification of discomfort.

Unfortunately, what it also meant was very limited movement of the right arm and the need to be constantly aware of what you would otherwise not give a second thought to: putting on a shirt, reaching for a pen, shifting into 5th gear. Every basic movement held the possibility of radiating pain, like flashes of evil genius lighting up the temporal lobe of a psychopath.

Pain that causes you to alter how you get along on a daily basis is ever humbling. You quickly realize how complex the body is and how interdependent its many moving parts and systems are in order for it to operate smoothly and efficiently. You cannot neglect one part and expect all the other parts to function perfectly.

Easter Weekend Training Camp

A complete loss. I'd hoped to build on Tuesday's strong 28 miles by back-to-back Easter weekend rides; a big Saturday ramble of 30 or 40 miles, followed up with an Easter Bunny chase on Sunday, another 30 miles or so. It was not to be.

Saturday, the arm was useless. I knew as soon as I woke that riding was out of the equation. I shook down Team Shad's medical staff for half a trampy doll* (25 mgs) and some jolly green meditation and repaired to the claw foot tub in which I soaked, uninterrupted, for almost two hours (having to drain the tub nearly empty twice in order to refill it with hot water piped from the upper reaches of Hades). I read about the cretaceous extinction in Elizabeth Kolbert's superb "The Sixth Extinction: An Unnatural History." Though not mentioned by name, the shad and its order clupeiformes probably emerged during the late cretaceous period and apparently survived the Great Impact, the asteroid that struck the Yucatan Peninsula and effectively brought the cretaceous period to a close (ending, as well, the reign of dinosaurs like the Mawgasaurus).

So the shad has longevity on its side.

Easter morning dawned raw and gray. Though the shoulder seemed better, and though under normal circumstances, the inhospitable 40 degree overcast day would not have been a deterrent, today was different. Dubstoevsky, softened by hot baths & pharmacological ingestants and facing the prospect of a mid-afternoon gastronomical event, gave about five minutes of serious consideration to riding before abandoning the thought completely.

The thing is, the arm is strong enough to perform 12 and 16 ounce curls without difficulty; the weight of the common table fork does not unduly stress the shoulder when lifted repeatedly from plate to mouth; and the possibility of inhibiting the calcific toothpaste dispersal by over-taxing the rotator cuff in the course of cycling, all these things convinced me that a second rest day was in order. To force a ride today, I told myself, would be to go against the inexorable tide of sloth and gluttony. It was a Christian holiday after all and the only good thing about the Church is the holidays that its tradition has bequeathed to our modern culture so that secular humanists like myself can enjoy a day off or a guilt-free opportunity for overeating and over-drinking.

So what of the "shaddian will" and the relentless energy that comes natural to the Alosa Sapidissima? Abandoned for a day. Dissipated in a cloud of orthodox incense wafting from the censer, floated away with the ethereal plainsong of the devoted.

Times like this are like being dragged out to sea by a riptide; one's only hope for survival is to yield to the tide and allow oneself to be swept along with the current until the current itself tires of its relentless pull. Only then should you regroup and reach inside yourself and, like Bullwinkle pulling a roaring rhino head from the top hat, yank up a cache of shaddian will and get your ass back to swimming.

* "trampy doll" is slang for Tramadol, a prescription painkiller


Sunday, March 13, 2016

Causeway Street Loop

A sort of mirror image of yesterday's ride, with a few key differences. First and foremost, I rode solo today so I rode at my own pace which, it turned out, was 1.1 mph faster than yesterday's outing with the western Mass lads. That meant that, for approximately the same amount of time, I managed two extra miles (31.9). The weather was slightly warmer, not as much of that hint of chill in the wind; and the wind was slightly less. Clear blue sky and bright sun.

I incorporated Causeway St in Rutland in today's effort, it comprised the far arc of the loop. A terrific, mostly traffic-free road, sylvan and visually delicious, the cardinal's bright, clear call ringing from the hardwood forest.

Causeway St, March 13, 2016, Rutland, MA

Hill top

Good to get in back to back rides. And now that the clocks have been set ahead an hour, the Barney's Monday night ride resumes this week (though rain is forecast tomorrow). Still, this weekend marks the beginning of a stretch of serious shad training. Or so is my intention.

One note of concern health-wise. I went to the orthopedist a couple weeks back about persistant pain and discomfort in my shoulders, my right being the most painful. I was quickly diagnosed with calcific tendonitis in the right one ("See that?"the sawbones said, pointing at a shark-tooth-shaped shadow on the x-ray, "that shouldn't be there"). Calcific tendonitis is a fancy name for the fact that calcium accretions have built up inside my rotator cuff and, when I move the shoulder in certain ways, the calcium shards grind and jab the tendon. Ouch!

Treatment is a couple cortisone shots (one of which I've had and that helped for a week or so; the next one is this week), followed by physical therapy. I have an 80% likelihood of resolving it without surgery. Though my left shoulder wasn't x-rayed the first visit (I was told that the orthopedist only likes to examine one limb per visit, which seems absurd to me), given that the pain is similar, just not as pronounced, it's a reasonable conclusion to draw that I have the condition in the left shoulder too.

And the bummer is that it's pretty obvious the cyclist's position of leaning slightly forward and, in a concave sort of way, gripping the handlebars is a significant contributor to the onset of this condition. Computing w/ mouse doesn't help either, nor does extensive driving employing the 10 o'cock - 2 o'clock steering wheel hand position. That's a triple combo of bad posture and I've been practicing all three for years. One of the few instances of a bad 3 combination. Alas, the calcium has come home to roost.

Hopefully I'm treating it in time and it hasn't gotten too far gone, or isn't getting worse too quickly. The pain was noticeable both yesterday and today and I made efforts to sit up more often and stretch my arms back and open up my chest as much as possible.

Further reports from the Team Shad medical staff in the days and weeks ahead.