A Sports Lover's Lament

The Comedy of a Torn Rotator Cuff

by Margery Phelps Childs
COPYRIGHT 1999

September, 1999
Atlanta, GA

I love sports! It's one of the reasons I enjoy being single -- I get to choose which games to watch on
television or listen to on the radio. If you visit my home on a Saturday or Sunday, you'll probably be
overwhelmed with my t.v. showing a tennis match or golf tournament, one radio blaring a college football
game and sports talk bursting forth from another. On the weekends I just can't stand to be separated from my
Yellow Jackets, Dirty Birds, or Braves.

My love of athletic competition is always tempered by a somber awareness of the dangers faced by
my cherished athletes and I, like many others, was haunted for weeks by the bone crushing blow suffered by
the great Joe Theisman on a broadcast seen by millions of fans. Terms such as "torn A.C.L.'s" and "pulled
hamstrings" are part of every sports lover's vocabulary, but my knowledge of rotator cuff tears became very
personal when I fell in my employer's cafeteria.

It all started when my feet found lettuce leaves scattered on the floor and turned them into the world's
first vegetarian skate board. Very suddenly I was gliding at a fast pace across a slick floor. Being a health
journalist, lettuce sliding would seem to be an appropriate sport. Had I been able to maintain the posture
required by my new-found athletic endeavor, my personal venture into the wonderful world of sports may
have had a different outcome. However, as it often does to my athletic radio and t.v. companions, fate threw
me a daunting change-up. My head and feet did an upside-down jack-knife (I felt like I had just left the high
platform but witnesses swear it was only the springboard) my only-source-of-income right writer's arm did a
backward spiral, my five-foot seven inch body did a perfect parallel vault, and the heel of my hand slam-
dunked the floor with a perfect dislocation of the shoulder.

Thankfully in shock, I sat in a pool of salad dressing, decorated with the ultimate tossed salad, topped
off with croutons. Security guards were on me in a flash. For a moment I thought I was Jack Nicklus
winning the Master's again. Reality set in when they gingerly lifted me, hurtling my right arm back into the
shoulder socket like an Olympian shot put. Mortified by my brief and disappointing career as a prize athlete, I
reluctantly provided vital statistics of my unheralded, single-entrant competition to Human Resources,
convinced that my foray into my beloved world of sports would surely end with full coverage and
compensation by another sporting group known as Worker's Compensation.

You would think the match was over since I had a technical knockout but actually my sporting life
was just beginning; I had only completed Round One. The Second Round commenced when I arrived at an
occupational medicine office on Peachtree Street where my shattered career, i.e., right shoulder and dangling
arm, were supposed to be put back together. Unknown to me at the time, the arrogant woman in a white coat
who did a cursory exam and proclaimed I had "a minor upper arm sprain" was not even a doctor. I was given
pills prescribed by a physician I have yet to see face-to-face and told, "get down the hall and start physical
therapy."
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 "My shoulder is really sore; so is my neck" I explained while trying to sound brave like my weekend
idols. "And what about my wrist? It's hurting pretty bad." She scowled at me while insinuating there was
really nothing wrong and left me standing alone while she went to perform some more malpractice.
Stumbling in nauseous pain, I found an unsophisticated physical therapy department where an angel
descended upon me with the accolades due a fallen sportsman: ice bags, ultra-sound rubs, exercises and a
device that measured my range of motion.

I was diligent about therapy, thinking of all my weekend pals who suffered through similar body
slams and recovered to again take their place on the gridiron, tennis court, baseball diamond or boxing ring.
At the end of three weeks, with range of shoulder motion close to zero and pain at a level of fifteen on a ten-
point scale, a defensive lineman from an obscure sport called Risk Management telephoned me. "Margie,
we're not satisfied with your progress. We're sending you to a Shoulder specialist." With this remark, Round
Two was finished.

My appointment with Shoulder Man was scheduled but fearing only a miracle could fix me, I was as
jittery as a three-year old filly before running the Preakness. Fresh out of the gates, however, I knew this
jockey would go the distance and make me a winner again. "I'm a writer and my right arm is my life," I
quickly explained. His youthful, casually dressed, well-built physique indicated to me that I just might be in
the hands of someone I could trust -- an ATHLETE? Whoopeeee -- relief at long last!!! Later I learned that
he was, indeed, exactly as I suspected: a former NFL football player. How lucky could a fifty-four year old
grandma with a bummed up shoulder get?

"Does that shoulder wake you at night?" was his first question off the starting block. "Every night," I
answered, trying to hide tears welling up in my eyes from weeks of protracted pain. "Well, it's not moving
until I see an MRI." He took a plain x-ray and explained that torn rotator cuffs are particularly painful at night
when you lay down because fluid in the shoulder joint puts pressure against the tear and causes pain. "I think
you dislocated your shoulder and you have a torn rotator cuff. You probably have a bone spur, too," my jock
doc explained. "I've been in physical therapy for three weeks and got steadily worse," I said, showing him
one of the exercises I had been doing. "No, no, no, no, no don't do that!" he yelled. Then he said there would
be no way of knowing how much more damage had been done by the misdiagnosis and wrong therapy.

My sporting doctor introduced his assistant who would schedule the MRI and handle insurance. Then
his nurse, a kindly lady about my age, issued my new athletic gear -- a shoulder immobilizer -- a wide
elasticized band that held my arm to my waist with various strips of Velcro. With instructions not to move
the arm, I was removed from the pitcher's mound by my new General Manager and sent to the dugout to await
my summons to MRI.

Four weeks after the injury I finally had an MRI which showed a torn rotator cuff and bone spur
pushed into my tendon, shredding it with every movement. Unless I had corrective surgery, Shoulder Man
said, I had zero chance of recovery and no use of my right arm. I felt like a wide receiver on the one-yard
line; my team was down by three touchdowns in the Super Bowl and the fourth quarter had just started. My
quarterback called the play. I had to catch the ball and run a hundred yards through the most painful obstacles
imaginable. But Round Three was over; I had survived the comedy of mis-diagnosis; I was on a new team; I
was still in the ring.

The Round Four bell sounded when I got a call from worker's comp carriers. "We're not authorizing
your surgery," a curt female voice said. I then found myself in the newest U.S.A. sport -- telephone tag. This
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is corporate America's way of shirking the long-outdated ideal called 'responsibility.' Not wanting to
participate in this unsanctioned meet, I created a new sport called "Threaten to sue the scoundrels," and my
rules were simple: "You pay for my injuries or you talk to my attorneys." This proved to be a winning game
plan (even though I really didn't have an attorney) because a week later the Umpire from the Liability
Insurance Carriers League called to say my date in the surgical arena with my athletic surgeon was scheduled.
By now, seven weeks into this marathon, the pain was incredible; I did not know if I could make it to the
finish line.

The morning of surgery I checked into an Atlanta hospital in an optimistic mood, like an athlete
before a big competition feeling the win before the coin toss. As a health writer and lecturer, I had told my
audiences hundreds of times, "do not go to the hospital without a patient advocate," so my twin sister, Mary,
filled this position on my team. Shoulder Man was the MVP, however, and duly awarded the title "Miracle
Doctor" because he first scoped my shoulder to assess injuries, then opened it to repair two tears in the rotator
cuff, remove bone and rebuild the capsule using a cutting edge technology he developed, before closing the
incision with plastic surgery sutures that left hardly any scar. It was his skill alone that pulled me through
Round Five. He pulled off a miraculous play. The next round was up to me.

Upon wakening in the recovery room I was told, "do not move your shoulder," and found myself in a
new piece of gear which I affectionately called my 'Coors Cooler.' This device kept a 38-degree liquid
circulating around my shoulder to limit pain. Like my wrist brace and shoulder restraint, Velcro also held this
harness together. How did athletes ever survive before the days of Velcro?

After recovery I was moved to the orthopedic floor, better described as The Training Camp for
Clowns. A slight fever, erratic blood pressure, nausea and vomiting, earned me a few extra days in this elite
training center so the nursing staff could perfect their comedy routines. They started by twice delivering a
pain med to which I am extremely allergic; Mary did not think this trick was so funny. Next, they needed a
toy for the quasi-Chris Chandler in another room. So, during my sister's overnight absence, they left me alone
in bed, flat on my back, for twelve hours. This turned my bladder into the world's biggest football. Their next
trick was to withhold pain medicine for more than an hour when I awoke up at 3 a.m. with two numb arms,
tingling feet and exploding pain in my neck. This trick may have soundly defeated me had Doctor Miracle not
called in a Neurosurgeon who is now playing a game called "Let's put the nerves in the neck back together."
The Training Camp for Clowns also played minor sports such as "we're not changing the sheets just because
you threw up on them," "we know you can't eat so here's a regular diet to tantalize you," "you want a bath --
you must be crazy," and "clean the room? -- what for?"

Realizing my body had provided enough material for the Comedy Club, it was time for me to close
my routine and make a hasty exit. Before I could leave, however, neuro-doctor got an MRI of my neck, chest
x-rays were ordered by another specialist because I had coughed up blood, a physical therapist delivered
exercise equipment and gave me some basic instructions, and an internist checked out my g.i. tract. When a
game has a lot of penalties and a lot of injuries due to dirty plays, everyone is relieved when it's over. That's
how I felt when I left that hospital. Just relieved it was over. I may have lost the Super Bowl, but there's
always another season.

Several days later my second string Defensive Co-ordinator, Coach Neurosurgeon, added his own
piece of Velcro equipment to my uniform, a Philadelphia neck collar to protect my spinal cord that had been
flattened in three places. Gleefully closing all the Velcro equipment that now held me together, my precious
five-year-old grandson dubbed me "the Velcro Nana." Surely, I thought, the next round could not be any
worse than this.

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 Being a health journalist I am somewhat familiar with the physiological process of pain.
Inflammation can be major contributor to this very unpleasant activity of the human body but I didn't want to
be a wimp so I didn't ask for any anti-inflammatory or pain drugs to give me even a little protection from the
beating I was about to undertake in the arena of rotator cuff rehabilitation. I should have remembered my
fencing years -- I would have been a fool to face an opponent without my mask and bibb -- yet I entered
Round Seven with no protective equipment whatsoever.

I easily related to my physical therapist's description of the shoulder joint being a golf ball sitting on a
tee but his manipulations were unbearably painful and he soon became my Prince of Pain. Determined to
recover anyway, I followed the advice of the hospital physical therapist who had told me to do my exercises at
least three times every day, more if possible. I quickly worked myself up to four and five daily sessions at
home. "Overdoing it," was not in my vocabulary. Besides, my noble employer had fired me because I was
"disabled" and they "no longer required my services." I had to find a job.

After physical therapy other patients were treated to ice-downs; but not me. Why was I different?
Was my surgery less complicated or my pain less? Why was the Japanese ball player regularly iced and I was
not? Doesn't a writer with two rotator cuff repairs, a rebuilt shoulder capsule, a dislocated wrist and three
spinal compressions that are potentially paralyzing deserve the same care as a pitcher? I was starting to feel
sorry for myself and I wondered if my athletic idols ever felt as bad.

At the end of four weeks I crashed, jerked awake every night with explosions of pain that dove into
my arm like a hot javelin. With no sleep and a temperature of a hundred and one I was dysfunctional. Instant
replays showed several flaws in my rehab game plan and the combination was a killer: no anti-inflammatory
drugs, no ice-downs, too much exertion. I finally swallowed my pride, like a Hulk Hogan opponent begging
for mercy, and called Doc Miracle. He immediately put me on the disabled list and prescribed anti-
inflammatory drugs. His assistant called my pharmacy.

"Take two with every meal," the pharmacist commanded. With six anti-inflammatory capsules a day,
pain quickly subsided to a tolerable level and a few days later I called Doc Miracle's assistant for a refill.
"Those pills are great!" I exclaimed. He called the pharmacy and within moments was on the phone with me
again. "How many of those pills are you taking?" he asked. "Six a day, just like it says on the label," I replied.
"Well, there's been a mistake. You can only take two a day." The druggist was the winner in this game plan --
the gross overdosing opened an old stomach ulcer. Would the comedy ever end?

Two pills a day were no better than a glass of water but my relief pitcher showed up when I received a
phone call from a doctor pal in San Diego. He said he'd send me the same anti-inflammatory he used to treat
Mark McGwire. "THE Mark McGwire?" I asked. If it's good enough for him, it's good enough for me so I
started taking the pills when they arrived by express; within 24 hours I felt better. Like my athlete idols, I
know my bad rehab is only a minor set-back, as is the wrist. Oh, did I forget to tell you? The insurance jocks
finally approved an MRI, five months after the fall -- now I get to have surgery to repair torn wrist ligaments.
And I got a new physical therapist, too. His Magic Fingers are painlessly correcting a complication that only
happens to one out of every 300 rotator cuff patients. I could only laugh when Doc Miracle explained the
uniqueness of my shoulder!

During my 40 weeks in rehabilitation, my love and admiration for athletes has risen to new heights and
Doctor Miracle is my inspiration. He, himself, has had fifteen surgeries and recovered from a broken neck.
Who would not be inspired by such a man? How can anyone subject themselves to so much pain and torture
just for the sake of a game? What is it about the human spirit that keeps us coming back for more as long as we
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can do what we love? Are athletic endeavors more than just competition? By conquering opponents on the
field, and physical and emotional pain off the field, is the athlete not showing us that we can overcome
adversity, both public and private? And by carrying our love and admiration into competition with them, do
they not include us, too, in those noble ideals?

Although my doctors and therapists say I will play tennis again, I just want to sit at my computer or
make long-hand entries in my journal. Writing to me is the game I play. It is my life, my passion -- just as it is
for the athlete whose name never becomes a household word but who gets on the gridiron every Sunday
afternoon because he loves what he does. Like the athlete, it's what I live for. By the way, a doctor friend in
Virginia just called to enlist my help with a new book -- on health reform -- he wants to know if I have any
ideas!

So here I am -- I caught the ball and I'm on the fifty yard line -- I just hit a line drive double and I'm
standing on second base -- I finished the first nine holes and I'm three under par -- I've survived, I'm still in the
ring, I won't give up, I know I'm a winner. Maybe I should just think of rounds seven and eight as two more
episodes in the comedy of errors that began 50 weeks ago with a very poor attempt at starting a new sport.
Laughing produces endorphins and endorphins make you feel better. Maybe all I need is a good, hearty laugh.

Better yet, the Braves are on t.v. -- I think I'll go watch a baseball game.