I have long pushed early and agressive treatment and to NOT EVER TRUST pain as gauge of when to start treatment. I have been point blank that the “head in the sand attitude” many have about starting treatment is flat out ignorant and that a late start to treatment may simply be too late.
I’m going to add an exclamation point to that statement with some recent personal experience. I have been spending many hours at the keyboard of late and started having some “shoulder pain” I was sure it was over use but when my usual methods of dealing with it Voltarin, heat, ice etc didn’t work, I sought some advice. Keep in mind I went 20 years without much more than NSAIDS (because nothing else was available so I was late to the biologic party)
I had already had one total shoulder so should have known I had problems. but the pain in my right was not that bad and certainly less than good old fashioned flare. Just annoying.
I was wrong. I just spent 2 days with reconstructive orthopods. The bottom line is They discovered from flat screens (talk about OLD technology) that I have a Mutilans deformation in my shoulder part of the ball is gone along with one of the “collar bone tips” so basically my shoulder is free floating be held by just the muscles when raised at all. Good news that I don’t have the spondylitis type PsA, bad news that It is the Mutilans type of PsA.
What COULD have been avoided can’t be any longer. I will have bone grafts to rebuild my collar bone and then a total shoulder (new ball and socket.) The nerves are jumbled some so the surgery will be done without any nerve blocks (ie pain management won’t be so good.) Because of the extent of the surgery, I will be in the hospital 2 days before the surgery for a full cardiac work up and monitoring.They expect about 4 hours in the OR and 5-7 days in the hospital for recovery and another week in the in-patient rehab center. and 2 more months of daily outpatient rehab. IF the surgery is successful I will still have life time restrictions and very limited lifting. (I will never be able to lift my GrandKids into my lap or buy a 12 of beer. (a six pack is on the outer limits of the weight limit) Even fishing is likely out of the question (unless I get skunked.)
Much of the expense will be out of pocket (about 150k, (I didn’t need my 401 K anyway) as it is “experimental surgery” The alternative is life in a sling with a belly strap holding the shoulder immobile.
I had no choice because the meds weren’t available and I started too late when they were. MANY of you DO have a choice. I’m pleading with you make a wise one. Cut the dramatics "Oh the meds are sooooo bad and soooo strong blah blah blah. Most of the resistance I see to treatment is really self pity…