The Dilemma

A dilemma is described as a situation in which a difficult choice has to be made between two or more alternatives, especially ones that are equally undesirable.   

This blog is about a dilemma between my mind and my body which is the worst kind for me – what I think versus what I feel. I don’t like competing against my mind as it can be unpredictable and, often illogical, but on this occasion, I had no choice.

We are all faced with difficult dilemma’s during our lifetime, some involving work, some more personal or even a moral dilemma.  I remember studying the well-known moral dilemma at school where there are 10 spaces on the lifeboat but 11 passengers on the sinking ship.  A decision must be made as to who will stay behind.

I find non personal situations much easier to deal with, although I don’t have the right answer for the lifeboat dilemma.   I had a very memorable dilemma when I was working in financial technology sales.  I had travelled from a previous meeting in Luxembourg to Frankfurt; my boss was joining me from London, so we had agreed to meet at the Bank’s offices. We also had a consultant joining us from our German office who was going to run the software demonstration and talk about the technical aspects.  I had already qualified the opportunity through previous meetings, so this was our big chance to prove our capabilities.  My client had invited key members of his IT team too.

On arrival at Frankfurt airport, I had a voice message from my boss saying he had returned home from Heathrow as he was feeling unwell.  I was confident I could run the meeting with my German colleague supporting me, so I wasn’t too concerned.   I arrived at the Bank’s Frankfurt office in good time, and 10 minutes before the start time, I called my German colleague as he hadn’t arrived.  He explained that he was waiting for me at the bank’s technology department which was outside the City and about an hour’s drive away.  Our meeting was due to start in 10 minutes, what to do?  More on that later.

My personal dilemma involved an injury after a fall.   Almost a year to the day, Jamie and I were travelling to Cornwall and had stopped for coffee at Exeter services.  On the way in, I didn’t see the curb and fell flat to the ground.  My left arm took the brunt of the fall, and whilst I was covered in mud with bleeding knees,  I was otherwise unhurt.  I knew immediately something was badly wrong with my arm.  The pain was intense, and I couldn’t move it. I cleaned myself up in the toilets and returned for coffee to decide what to do.   Jamie is a trained Sports Therapist and his studies covered anatomy and physiology.  Between us, with me describing my symptoms, we concluded that my arm probably wasn’t broken but I had either torn or ruptured the tendon to one or more of the muscles in my shoulder (rotator cuff)

We carried on to Cornwall and, luckily, I had all my drugs with me.  Thankfully my good friend Dr Google was also in Cornwall and advised me that injuries such as mine were helped with prescription anti-inflammatories; what a stroke of luck, I had the world’s biggest supply.  If my arm wasn’t broken, A&E couldn’t do much apart from x-ray, prescribe me drugs I already had and refer me to a specialist, so I decided not to go.  As readers of my blog will know, A&E is not my favourite place.

My pain levels were high during that week and, with Jamie’s help, I started on some very basic rehabilitation movements.  I had a Rheumatologist appointment scheduled on our return so I knew I could ask my consultant to refer me for a scan.

Jamie had been correct, during the scan it transpired I had completely ruptured the tendon detatching my supraspinatus muscle from the bone. This is the muscle that elevates the arm and moves it away from the body.  The supraspinatus muscle is the most important muscle of the rotator cuff.  Surgery to repair it often involves re-attaching the tendon to the head of the upper arm bone.  When surgery is combined with a good rehabilitation effort, rotator cuff surgery does allow people to regain much of the lost comfort and function in shoulders.

Now the dilemma!

After rotator cuff repair surgery, you need to plan on being less functional than usual for twelve or more weeks after the procedure. WHAT!  Now I am someone who is always active, probably worryingly so!  I find it difficult to sit down and relax and when I first bought my Fitbit, I wasn’t surprised to learn that I was active for 13 out of 13 hours per day, meaning more than 250 steps in any one hour.  This year my average steps are around 15,500!

Apparently, the shoulder cannot be used with the elbow away from the side for 3 months after repair. Lifting, pushing, pulling and many activities of daily life place stress on the rotator cuff causing tension on the repair risking failure of the surgery.  Driving, shopping and performing usual work or chores are not recommended. Plans for necessary assistance need to be made before surgery. Oh joy, I knew I would be the worst patient imaginable.

Due to my ankylosing spondylitis, in my mind, if I don’t exercise, I get sore, my pain levels increase, and my body seizes up and I can’t stand up straight.   Whilst some of this thought process is based on experience and some based what I have read and been advised, without doubt, a large psychological element was factored in.   In my mind exercise increases my flexibility, improves my posture, which builds confidence and reduces self-consciousness about not being able to stand straight.   My sleep can also be a bit random, but if I am tired after exercise I sleep well.  When I don’t exercise, my stiffness and pain is significantly worse, which results in more pain at night too.  I also know exercise contributes to my overall wellbeing.

I did think seriously about the impact of not having surgery, however, my mind won!  I chose not to have the operation even though my arm was very sore with limited movement.  I decided to rehab the hell out of it and, if necessary, get other muscles to compensate and this is what I did. 

Three months later I met with a very good Consultant who I immediately liked as he had lots of Cornwall type leather and beaded bracelets around his wrist.  He thought my rehab efforts were excellent and I had gained significant movement, most probably with other muscles compensating for the ruptured supraspinatus as it won’t repair on its own.  My arm is still sore, but I push through the pain with every gym workout; I would never recommend this course of action to others, but it was the right decision for me.

With regard to my work dilemma, I called my client from their reception and he came down to meet me.  I explained the situation and we agreed to reschedule the meeting.  Clearly, I couldn’t add sufficient value on my own to warrant an hour of his technical team’s time. 😁.  It’s often easier to admit mistakes and apologise rather than to try and cover up.  My German colleague and I had met with this client twice previously and always at their IT office out of town.  I hadn’t advised him this meeting would be in the City.

I reflected on the definition of a dilemma and thought it to be very accurate. I did have a difficult choice between two alternatives both of which were equally undesirable. I chose the right one to satisfy my mind, whether it was the right decision for my body, only time will tell.

Autoimmune disease, simply put, results in your body attacking itself in some way. Next week my blog will cover another symptom of autoimmune which drives me crazy. 

Thank you for reading my story, until next time xxx

Published by meadandrea

Blogger, writer, author, love to travel, photographer

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