À La Carte: IDIOPATHY
[creative nonfiction]
This is the year I got old.
The orthopedist says there is little I can do. Not about growing older—I already know that—but about my left shoulder. It’s not the athletic injury I thought it was, and there’s no definitive cure. It simply has to run its course, he says, dismissively. The only thing I can do is a daily series of painful stretches that literally have me climbing the walls.
I want to strangle him.
I have Frozen Shoulder. The medical term is Idiopathic Adhesive Capsulitis. Another name, one that is carefully avoided around women my age (early fifties), is Menopause Shoulder. An insulting, yet apt term given that seventy percent of people affected by this idiotic condition are women between the ages of forty and sixty If only our hot flashes could thaw our frozen shoulders, we’d have no need for indifferent male orthopedists.
No matter what you call it, it’s an excruciating and disabling disorder with no known specific cause other than inflammation. The signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
One or three years? I’m not going to make it.
I’m used to being in control of my body. I’ve always been very active and crave movement and the endorphins that come with it. I recently bragged that I can still touch my palms flat to the floor and plan on doing so well into my eighties and nighties. But the nonsensical adhesions in my shoulder prevent me from sticking to any part of my daily workout routine.
It’s as if someone squeezed a tube of Krazy Glue inside my arm, bonding every muscle, tendon, ligament, and tingling nerve together, then sealing the shoulder socket in place so that it can no longer rotate in the cuff. The joint is so tight and stiff that it’s nearly impossible to carry out simple movements. I can’t raise my left arm past my hip. I can’t pull my hair back into a barrette, since that requires two hands. I’ve had to stop running because, not only does the jostling make me want to scream, but I literally get stuck in my sports bra (the sight of me half in and half out makes my husband laugh as he unbinds me). The pain is usually constant and even worse at night, so I can’t sleep. I’m exhausted, irritable, anxious, and depressed.
After two months of suffering the futility of the orthopedist’s pessimistic treatment plan, I finally get up the nerve to seek help elsewhere.
* * *
The physical therapy office takes up the entire second floor. It is crisp and clean, with youthful, fit therapists walking the halls and guiding aching bodies to one of dozens of rooms. There are “group” rooms, where sweatpanted patients sit on large inflated blue orbs or lie prone on tables. I look at the older men and women, with their hunched postures and stiff limbs and pray that I don’t end up like that.
Someone brings me to a private room. New age music filters in soothingly from hidden speakers. It makes me want to take a nap. On the wall is a large, framed photograph of a naked woman’s toned, smooth legs diving into a crystal blue pool. The faceless model is the epitome of health. Her perfect, youthful buttocks glisten as they hit the water.
I’ve been told this physical therapist has frozen shoulder expertise. She enters, takes out a protractor-like tool, has me move my arm in various directions—none of which I can do—and assesses my lack of mobility. It is substantial. She jots a few things down in my chart.
Take your shirt off, she tells me. She is lean and fit in tight belted jeans and a form-fitting, black t-shirt emblazoned with Relax, we’ll take care of you.
She has not given me a robe, nor is there one in sight. I struggle to lift my baggy t-shirt over my head. This is one of the things I can’t do, I say. She nods, knowingly, and helps me undress.
She leads me over to the therapy table and places bolsters and rolled towels under my neck and shoulder so that I’m able to lie on my back. Helpless and exposed, I let her try to move my arm again. She is both gentle and firm. I know this hurts, she says, as I wince. She palpates each adhesion with her fingers, moves my arm in ways that it refuses to move. I bite my lip and resort to the meditational breathing I did during childbirth more than two decades earlier.
Let it go, she says.
I try, but I’m really resisting more. Letting go is not something that comes easily.
I can’t help you if you won’t let go, she says.
I’m lying on the table, bare-shouldered, my un-toned belly uncovered, my well-worn bra strap dangling limply off my shoulder, when her male assistant (I’ll call him Ryan) comes into the room. I can’t see him, but I hear his responses as she tells him what to do.
Fifteen minutes on the trigger point, she instructs him. She then explains to me that there is always a point of origin to this type of pain and that if Ryan can locate it—and if I can release it—I’d start to feel much better. Try to let go, she says, dimming the lights as she leaves the room.
Ryan comes into view then. He can’t be more than twenty-five—the same age as my older daughter. Thick brown hair, big brown eyes, strong and kind and fully dressed. He adjusts the small towel to cover my half-exposed breasts, and another so that it covers my belly. He places another bolster under my knees to relieve the pressure on my pelvis and hips.
Let’s find that trigger point, he says. He touches me. Gently moves my hair out of the way—I still haven’t been able to pull it back and it’s long and messy over my shoulders. His dips his fingers into a container of lavender-scented lubricant and slides them under my left scapula.
Tell me when I’m on it, he says.
I strain to keep my eyes open as he explores the sore spots in my back. I have no idea what I’m supposed to feel.
Is that it? I ask when he probes a particularly tender area. I’m not sure.
It could be, he says. It’s definitely tight. The palm of his hand rests on my latissimus dorsi muscle, his thumb touching the back of my shoulder. Once in position, he applies pressure with his index and middle fingers.
Ow.
Only Oh. I suppress a moan. It’s been a long time since I’ve been touched by such a young man. I could be his mother. I really am losing my mind.
You ok? he asks.
Yes, I say. I’m fine.
I’m going to apply pressure until you release it, he says. Let me know when you feel it go. He is patient and silent. His fingers readjust ever so slightly so that they hit the entire trigger spot. The knot doesn’t give. He’s just behind me and I can no longer see his face. But I can hear his relaxed breathing, the parting of his lips as he—I don’t know, licks them? Swallows?
We sit like this for what seems like hours. His fingers start to shake and I feel him readjust them again. His hand is getting tired.
How is it now? he asks. Does it feel like it’s letting go?
I can’t tell. I shift a bit, leaning into his fingers, hoping for release, not wanting him to stop.
But he does.
Is he disappointed? I know I’m disappointed.
It’s ok, he says. Sometimes it takes a while. But this should help a little. He stands. You can sit up. I’m just going to clean off your shoulder.
I sit, clutching the tiny towel to my chest. The one over my belly falls to the floor. Except for the minimal coverage my bra provides, I’m naked again from the waist up.
Ryan brings a clean towel over my shoulder and back, the spots that he’s just been working on, and wipes off all the lavender goop. He does not replace the strap of my bra. See you next week, he says, turning up the lights. The door clicks shut behind him.
I sulk for a moment before struggling first to pull up the bra strap and then to raise my arm high enough to get my shirt on. I catch a glimpse of myself in the mirror. Old is what I see, and turn away.
* * *
My husband and I have been together since we were nineteen. It’s a long time, I say to him. It’s forever, he says, laughing.
We lie in bed that night, and I struggle to find a comfortable position. I haven’t been able lie flat for weeks because of the pain, so I prop myself up on pillows with a rolled up towel under my bad arm like they did in physical therapy. Still, I get little relief.
Do you still love me? I ask.
He turns and looks at me.
Even though I’m old? I say.
You’re not that old, he says, kissing my shoulder. You’re going to be fine.
I so want to believe him. On both counts.
* * *
When he was forty-eight, my husband had a motorcycle accident that resulted in a complete fracture of his fibula and tibia. It happened at the end of our driveway, and when I heard him go down, I ran out to find him clasping his ankle to keep the sharp, jagged bone from piercing through his shin. During emergency surgery, the orthopedist inserted a 14” titanium rod from the knee to the ankle, held in place by three titanium screws.
Later, these screws would become a problem. You could see them through the skin. The one in the knee was especially protruding and uncomfortable and eventually had to be removed during another surgery.
That was a real injury, and my husband has the scars and chronic pain to prove it.
My frozen shoulder is not a real injury. But it is the first of many betrayals I now know to expect from my body. I massage it, willing it to loosen up, wishing I were still as lithe as that naked woman on the wall.
* * *
Over the next seven months, my physical therapist, Ryan, and I get into a groove. I become less self-conscious—and less distracted—and my shoulder begins to thaw. It’s a fascinating process, once I stop resisting. “Let it go” takes on a new meaning as my arm becomes something separate from my body. I’m able to let go of some control without letting go of me.
It becomes less awkward with Ryan, too. After someone hits your trigger point, you can’t help but want to know more about him. I start to ask him questions while he works on me, and he answers. He tells me about his girlfriend, his sister, his dreams, what he wants to do with his life. He reminds me of my daughter and her friends with their whole lives ahead of them. If I were younger, he might have flirted with me, and vice versa. Then again, if I were younger, he would never have been allowed in the room because my half-naked body would have made it inappropriate. So I listen, because that’s what a mom does. I’m back in a familiar role. Now I know what to do. Now I know what to say. Now, whether I like it or not, I’m reminded who I am—and how the world sees me.
