June 24, 2018
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My gimpy shoulder, Part 1

By Dr. Erik Steele

I always get what I want, so when I wished I could be more like TR Reid (best-selling author, probably rich, bum right shoulder) I got what I asked for and now have a bum right shoulder. And it’s not just bum, but probably permanently bum unless I go see a surgeon and get it cut open and fixed. This really ticks me off, because having an important joint that starts causing me problems out of the blue, will not heal on its own and may permanently limit my ability to do everything I want sounds a lot like getting old, which I’m not.

Eternal optimist that I am, I thought I would give being like TR Reid another shot by stealing his idea of looking at American health care from the perspective of a gimpy shoulder and add a twist of my own by using the same lens to look at our health care as we age. This will require me to talk about my health problems, which also sounds like what people do when they get old, but again, I’m not.

Just about everyone who comes to me with a dysfunctional joint wants an MRI scan to identify the problem. Me too, because I know it would tell me what’s screwing up my pitching arm. But I have to ask myself the first question I ask patients with a bunged up body part before they get a test to identify a problem: Does the problem we might find need to be fixed? Not everything wrong with us needs to be fixed, and fixing things comes at prices — pain, risk of complication and money out of our pockets — that may not be worth it.

That’s especially true if it’s a problem produced by our aging, because aging is going to bring us a slew of problems and we cannot fix them all. Fixing things also comes at a social cost: The more we spend on ourselves fixing things that we could put up with, the more our health care and health insurance costs and the less money there is to fix bigger problems in someone else.

As I think about my shoulder I need to take into account that it’s just flat out irresponsible for anyone — even a physician with good insurance who could see the World’s Greatest Shoulder Surgeon anywhere in America — to spend money on their health care without really thinking through whether that’s money well spent.

Which takes me back to my right shoulder, and whether it should be fixed. So here’s what I have asked myself in order to answer that question:

1. Is it hurting all the time and thereby making life miserable for me? No — it doesn’t hurt most of the time and rarely interferes with my sleep or requires me to take pain medication. In fact, I would not know I have a problem except that it hurts like hell when I try to do certain things, so much that I can’t do those things any more.

2. Are the things I can’t do anymore really important to me? Well, if I wore a bra I could not unhook it, but I don’t, so that’s not a problem. But my right arm is my best power tool and I now can’t do much overhead work with it, a real problem for a guy who likes to renovate his house. I also cannot throw snowballs at my nephews and footballs to my daughters, which really pisses me off because I have — make that had — a great right arm.

But I can still do woodworking and play golf without any pain, lift a camera to my eye and walk hand in hand with my sweetie. And I have figured out that graceful aging is partly the process of giving some things up without spending a lot of time whining about the loss.

So no MRI for me, because no matter what it shows, at this point I’m not doing anything about it. TR Reid would be proud of me.

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