By Paul von Zielbauer
If an injury isn’t causing chronic pain or a diminution of my quality of life, maybe the best choice is to avoid the knife and learn to live with it. But where is the line, and on what factors should one decide whether to have surgery for non-acute injuries in midlife or later?
In mid-May, I elected to have surgery on my right shoulder to repair two torn rotator cuff tendons and nagging daily pain produced by a third tendon that connects the biceps to the shoulder. A surgery of choice, to be sure, but also one required to alleviate significant nightly pain that was disrupting my sleep. (If an injury messes with your sleep, it’s time to get serious about fixing it, to avoid even bigger aging-related issues, including cognitive decline and an even greater propensity for injuries.)
After examining me and the MRI readout showing the tendon tears and strains, the surgeon first suggested physical therapy, which seemed, to my longtime reporter’s sixth sense, to be too quick and too convenient a response. Since it was obvious that eight to twelve weekly 30-minute personal training (PT) sessions, which for joints are usually focused on strengthening the muscles surrounding tendon tears, would help my sleep or athletic performance, I asked the surgeon, “Can we just do the surgery so we fix the problem?”
He immediately assented — which at the time I took as confirmation that he himself knew that PT alone was a less satisfactory solution for my long-term health and quality of life.
But now, two months into my recovery, I’m wondering. Not whether this surgery was the right choice for my right shoulder — it was, given how much it had compromised my sleep and ability to do routine strength training exercises — but what I’d do if (when?) I will blow out another joint in the future.
The nightly ice pack required to calm post-op shoulder pain. The monotonous, time-consuming physical therapy exercises that are the opposite of fun and invigorating. And perhaps most of all, the inability to do any upper body strength training while watching my chest, shoulders and arms turn to fleshy mush. These are all predictable and necessary phases of recovering from elective orthopedic surgery.
But they also add up to an emotional toll as much as a physical one. One that I’ve now resolved to study more carefully in the event of any future injury …
And, wouldn’t you know it, just as this resolution took hold, it happened: My always-steady right knee, the one major joint in my body that had never given me so much as a twinge of pain in life, swelled up two weeks ago, after an hour playing tennis against a ball machine. Walking, much less running and sitting cross-legged, is now painful. It’s not going away with rest, ice and elevation.
I don’t know for sure, but it feels like a minor meniscus tear.
Does it keep me up at night or distract me at work? Thankfully, no. Does it limit my ability to do what I want to do on the tennis court or in the gym? Unfortunately, yes. Will I decide, assuming it is a repairable injury, to have surgery, if it offers a high-percentage chance to get back to my baseline? Honestly, I don’t know.
One of the major advantages of hitting your 50s is the improved ability to think strategically and anticipate what decisions will make you happy or not happy. One of the downsides, on the other hand, is a reduced willingness to go through more daily pain, ice, NSAIDs and physical therapy routines just to keep up with the ball machine.
And there’s one other important consideration: the peace of mind of not further entangling oneself in today’s health care system — a hidden cost of physical well-being that, I would venture, most of us don’t think enough about. (Creators)