As I said in the last installment, I would be going for X-rays on the shoulders before I went back to see my surgeon. So, that’s exactly what I did recently, and it was the usual pain in the butt that it always is.

Whoever designed X-ray. MRI, and CT scan tables has obviously never suffered from any joint disease. The surfaces that those tests are conducted from are made of metal, have no padding, and are often cold as ice. As someone who has Rheumatoid Arthritis, I can tell you contorting yourself into positions that an acrobat would find uncomfortable while on top of these tables is a feat that strains the body heavily. But, like always, I sucked it up and got the X-rays started.

Since my surgeon wanted very specific images from different angles, I was forced to bend my body into at least six different positions. The first position was the worst, and it involved me lying on my stomach while holding my arm out and up at the three o’clock position. Since the reason I was getting my shoulders replaced was precisely because I could not move my arm into the three o’clock position, it felt a bit tragic when I told the nurse I couldn’t do it. She told me to “do the best I could.” I won’t sugar coat the experience when I tell you that it hurt, and it hurt a lot. Not only that, but the technician taking the films had obviously never attempted to take X-rays from that position before, because she attempted it four times on one side before she got it right. Each and every time, I had to hold my breath and remain still for at least 30 seconds. That may seem like an instant, but for someone whose joints are in the condition mine are in, it is an eternity.

Eventually she finished all the images, and I got dressed and went home. I knew I would be hurting for the rest of the day, but I had no time to stop and cry about it. I had to get ready for the trip to the surgeon the next day. I had received copies of my X-rays from the local office where I got the films done, so I decided to take a peek at them myself. What I saw was discouraging, to say the least.

When I held the films up to a light in my room, I noticed that both shoulders had a considerable amount of bone missing. The left shoulder was worse than the right, and on that left side one half of the top end of my arm bone was gone. Even without medical training, I could see that it was well past time to get my shoulders replaced.

The next day, I got up and schlepped into Manhattan to see my surgeon at the Hospital for Special Surgery. It was the same doctor who had replaced my hip fifteen years ago, and he was still at the top of his game. In addition, he had a wonderful bedside manner, so having him replace the shoulder was a no-brainer. He was in surgery most of the week, so he only had hours a few days a month. I arrived at the hospital and checked in with his secretary. Surprisingly, there was only one other patient waiting to see my surgeon. Usually, the waiting room is entirely full, and just getting a seat can take time. Good luck for me, I thought, since the longer I stayed in the hospital the more it would cost to park my car. So I played Fruit Ninja on my iPhone for ten minutes before I was finally shown into an exam room.

I only had to wait a few minutes before my surgeon came in and greeted me. Cutting right to the chase, he put the X-rays of my shoulder up on the light board. Instantly, he nodded his head. The only question I had for him was to ask if there was enough bone left to perform the operation. He told me there was more than enough. What a relief! Then my surgeon said “but..” He went on to tell me that due to the advanced state of decay in my shoulder joints, I would need to go for further testing. In this case, that meant a MRI and a CT scan. My surgeon explained that Rheumatoid Arthritis can eat away at a ligament in the shoulder, and he needed to know if that ligament was still intact. If it wasn’t, I’d need a special custom made shoulder implant, and I’d also have trouble getting a higher degree of mobility after surgery. Hopefully, though, the ligament was still there, and I could use a regular “off-the-shelf” shoulder joint.

So, I got both good and bad news this visit. Well, potential bad news, since I have to go for further testing before we know for sure what state my shoulder muscles are in. This also means more minutes lying on a cold, hard, metal table. Not to mention the horrible MRI machine, with its loud noises and the claustrophobia-inducing metal donut hole. There is no avoiding it, though, and I have endured worse.

So, I took my prescriptions for the tests and scheduled the scans all on the same day at the Hospital for Special Surgery. I would come to the hospital early in the morning and leave in the afternoon, making an entire day of it. I also scheduled my Rheumatologist appointment on that day, thus killing three birds with one stone. I’m truly hoping that I will be able to use a regular shoulder implant, mainly because it means I will be able to regain most of my shoulder mobility. If not, I’ll have to get by with 75-80% of the range a normal shoulder has, which, I suppose is still better than the 40-50% I have now. Either way, I have the next step laid out for me, and I will keep you all informed of my progress. I have tentatively scheduled the first replacement, the left shoulder, for September 26, 2011, so if all goes to plan, D-day is only one and a half months away. Stay tuned….