The Wages of Time

On the cusp of my 78^th birthday, I got some very bad medical news or what one peer-reviewed report called “a catastrophic failure.” Here’s what happened:

In April of last year, I had what is known as a reverse shoulder replacement or arthroplasty. My rotator cuff tendons were in tatters. The arm hurt all the time. The solution was to remove the ball and its receptacle in the joint, replace them with a plastic socket and a steel ball, and reverse them for better mechanics.

Recovery was glacially slowly but definitely coming along until a month or so ago when, sitting in my chair, minding my own business, I felt a bolt of sharp pain and tightness and immediately knew something was wrong. A common X-ray revealed that the screws holding the baseplate holding the steel ball broke in two. A catastrophe. This is certainly not unknown in the orthopedic surgeons’ universe, but not common. Those busted screws are there right now, until all surgical options are explored and a new plan is hatched. I’m in the middle of this. The outcome could be a final resolution to the whole problem, hopefully, eliminating the pain and bringing shoulder function back to near-normal.

Why am I telling you this? If you are paralyzed for any length of time, and you exercise vigorously, only use a manual chair, drive, and perform enough weight bearing transfers and other shoulder-straining movements, you are likely to have serious shoulder problems. Arthritis, rotator cuff tears, my kind of rotator tendon deterioration, and fifty other variations I know nothing about. I don’t know much about this one, except that it is likely the result of downward pressure on the joint exerted during the life of the screws or perhaps the cumulative pressure of twenty-six years of all those transfers and arm lifts.

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From day one of my paralysis, I thought only of getting stronger and having more endurance, at least equal to the levels I had before the paralysis. The same mind-set carried over, just different routines for a different body. I don’t recall anyone telling me about the cumulative stress I was putting on my shoulders. I’m not sure what difference it would have made. I was doing what my gut told me to do – stay fit, keep working at it. It never dawned on me to slow down, count my transfers, or switch to a power chair.

Perhaps there were ways I could have been more aware of the stress and staved off shoulder surgery. But, in retrospect, all that movement and effort was essential to remaining as independent as possible. The freedom of hopping into the car with no assistance, lifting a 12 to 15 lb. chair into the passenger seat, going out, making a stop or two, coming back, and doing it all in reverse helped offset my own fears of feeling helpless and dependent.

That was all well and good, for both body and soul, but now I am paying the price, a steep price, for what I did or overdid. I no longer drive, use a sliding board (with assistance) for nearly all transfers, and ventured out much less. Another surgery could return me to the life of a rugged, independent 78-year-old and a renewed capacity for risk and adventure. Or I’ll have to start shopping for a power chair I can live with.

If you are a para in a chair, love your shoulders. Of all your working body parts, they are the key to remaining free, strong, and mobile.