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wshaffer

September 2021

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So, my dentist is encouraging me to do Invisalign to straighten my lower front teeth. I have a bit of crowding in my lower jaw, and one of my incisors slightly overlaps its neighbor. While I don't doubt that having straight, uncrowded teeth would improve the ease of keeping them clean and tartar-free, I'm reluctant for two reasons.

The sensible reason is that by far the biggest improvements in my oral health have come from just being more consistent about brushing properly, flossing, and using antiseptic mouthwash. While I've come a long way on all these habits, I think that maybe I'd be better off investing more time and energy in getting even better at that, rather than spending money on orthodontics.

The unsensible but far more powerful reason is that I spent a goodly chunk of my young life wearing braces and a headgear to correct an overbite. And the thing that got me through the worst parts of the experience was the promise that "when you grow up you won't have to do this any more." (And when I turned 18, I ceremoniously packed up my retainer and stuck it in a drawer and never wore it again. I was a horribly literal child.) And even though the rational part of my brain knows that Invisalign would not be nearly as dreadful for a whole host of reasons, just the thought makes my inner twelve year old howl, "Nooo! You promised I wouldn't have to!"

Normally, I have great respect for my inner twelve year old, but in this case, I think her judgement may be suspect.

On the other hand, I also think my dentist's judgement may be influenced by the prospect of getting to sell me expensive orthodontic treatments.

It's probably too much to hope that someone's actually done a good study to look at whether people who get modest tooth-crookedness corrected actually experience better dental health outcomes in the long term, but I'll have to hie me over to PubMed and have a look.
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Progress!

Nov. 15th, 2013 10:39 am
wshaffer: (Default)
So, today at my PT appointment, we measured my range of motion and compared the numbers with what they'd been on my first visit:
lifting arm straight up in front of me: range of motion increased from 130 degrees to 160 degrees
lifting arm straight up to the side: range of motion increased from 110 degrees to 160 degrees
holding elbow at side and rotating lower arm outward: range of motion increased from 30 degrees to 60 degrees
My PT doesn't record a numerical value for the "reaching up to scratch between your shoulderblades" motion, but he considers me now able to reach my "mid-back" rather than just "lower back".

I've still got some way to go, but that's a very nice rate of improvement!

As my reward, I get a new batch of exercises to add to the ones I'm already doing. Wheeee!

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Nov. 8th, 2013 09:51 am
wshaffer: (not-helpful)
So, having gone over my MRI results now with one doctor and two physical therapists, I now understand that while I do have a small rotator cuff tear, it's not really the problem. The problem is the inflammation that my doctor talked about, more properly known as "adhesive capsulitis" or, colloquially, "frozen shoulder". Which might be the result of the rotator cuff tear, or the cause of the rotator cuff tear.

One of the things that I've found funny is that both of the physical therapists I've seen have gone out of their way to tell me how awesome it is that I've started treatment this early. Having read this article, I now understand why: by getting a cortisone shot and starting physical therapy early, I might have cut my recovery time down to months instead of years.

I'm trying very hard to look on the bright side of all of this. I think I'm mostly succeeding.
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Had my first physical therapy appointment today. The good news: the therapist agrees with my doctor that I'm very likely to get better without surgery. The bad news: It's going to be slow (months?) and painful - the exercises he's given me basically boil down to "move your arm to the point where it hurts, and hold it there for a bit."

The therapist would like me to avoid overhead pressing and rock climbing for now. Other than that, I can do whatever.
So, I just had my follow up on the MRI of my shoulder. Basically:
* I have a "very tiny" partial tear of the rotator cuff.
* I have "a lot" of inflammation in the shoulder joint.
* My shoulder is structurally "totally normal".

The upshot of which is: Left to its own devices, the injury will probably just get better slowly over the course of the next few months. In the hopes of hustling it along a bit, we're going to try physical therapy and follow up in a month. There is an outside chance that if the inflammation is stubborn, I might still need surgery, but it's pretty unlikely.
So, just to briefly recap, since I don't remember how much I've posted about this where: A little over a month ago, I noticed a slight twinge in my left shoulder when putting my arm over my head to pull on a T-shirt in the morning. Over time, this progressed from a slight twinge to a definite twinge to fairly serious pain when reaching overhead, or up behind my shoulder blades, plus a constant dull ache in the shoulder to add to the fun. So, I took myself to the doctor, who X-rayed me, and found nothing wrong by that method. Thus we progressed to higher level radiology: the MRI.

I drove up to the imaging clinic in Atherton this morning, bright and early. I brought my iPod with me. Having seen in their Yelp reviews that they provide music to listen to during your scan, I hoped, correctly, that they'd let me provide my own. It probably surprises precisely none of you that I have definite opinions on what sort of musical accompaniment I'd like for being immobilized for half an hour inside a cramped metal tube. (I chose Fields of the Nephilim's Elizium.)

They had me remove all the items from my pockets, and take off any metal-containing items. Then I got to lie on a table and sort of wedge my shoulder into a box-like thing, and then the tech wrapped a pillow around my left arm, and put another pillow under my legs. We put on the headphones and fed me into the machine.

Wow, that thing is cramped. I'm not sure how they fit people much bigger than me in there - my arms were pressed tightly against the sides of the tube, and there were only a few inches between my face and the inside surface of the machine. I'm not notably claustrophobic, but I still found it most comfortable to keep my eyes shut most of the time just to keep my mind off of how little space I had.

There is one thing that makes shoulder MRIs kind of tricky - you have to be careful not to breathe too deeply, because that will make your shoulder move and blur the scan. It took me a while to get the hang of breathing regularly but shallowly. At first I'd breathe really shallowly, feel like I wasn't getting enough air, panic, and then instinctively take a nice deep breath to calm myself, remember that I wasn't supposed to take deep breaths, and start the whole cycle over. My first scan wasn't usable, but after that I seemed to get the hang of it, because the remaining five went without a hitch.

And even my music had a suitable sense of the dramatic - I was regurgitated forth from the machine, blinking in the light, to the final triumphant chords of Fields of the Nephilim's "And There Will Your Heart Be Also".

I have a CD to take with me to my next doctor's appointment on Wednesday. (Really? Physical media? They can't just transfer the files?) We'll see what happens then.
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