I see a new doctor today. But any hopes I might have had about the tendon damage as a possible avenue for recovery were consummately dashed by my physical therapist this morning. She read the MRI report and said it was unlikely that particular injury was responsible for the cascade that led to my pain.

I kept up my customary chatter, but inside, I was crushed. Because it meant that, storytelling aside, I still don’t have an explanation for the amount of pain I’m in. I managed to keep up a string of a conversation as she manipulated my shoulder, as she always does, trying to pull it back into place against my stubborn ligaments, as she always does, not having any effect, as she always does. I left there an hour later in more pain than I had been when I got there, as I always do, frustrated and demoralized, as I always am.

I wanted to get up and walk out before she even started the manipulation.  I was suddenly overwhelmed by the sheer futility of it. I kept thinking Momma Ape is right. I shouldn’t still be in this much pain. She’s not the only one; a number of friends, including some with chronic pain problems of their own, have been telling me the same thing, for weeks now. And they’re right.  They’re all right.

After all of this time and all of this treatment, I should be getting noticeably better. And physically, my posture and range of motion has improved, and my upper back muscles are starting to come back on line, although they still tire incredibly easily. But my pain hasn’t improved at all. Take away the nerve ablation, and all I’ve done in the last eight months is add to the list of things that hurt, rather than subtract from it.

I leave to see this new doctor in about an hour. I’ve compiled a packet any of my professors would have been proud of; complete treatment history, MRI scans and reports from the radiologists; physical therapy history and evaluation report; blood work; prescription and therapy list noting dosage, efficacy, and whether or not I’m taking it currently; and a contact list for my doctors, physical therapist, and psychologist. It’s A-level work. Not that it matters.

How much hope is too much? How little is not enough? People say not to have expectations, but they might as well tell me not to breathe. What am I supposed to think about, if not the future? It’s not like the past fills me with warm fuzzies.

I’m terrified that the doctor will tell me there’s nothing he can do that hasn’t already been done and I’ll have to keep going, to another doctor, and then another one, and another one after that. And in another six weeks, school will start and I will be no closer to a diagnosis, a treatment, or a solution. So I want to have at least a little hope, some small expectation that something good will come of this new appointment, because the worst-case scenario is so bad I don’t have the emotional fortitude to try to prepare myself for it.

So I will try to busy myself for another hour or so and try to distract myself and maybe squeeze a few tears out before I go, to try to wring as much emotion as possible out of my voice so I can be as dry and clinical as the doctors always are when I get there.

And then I will have gotten through the before. Next comes the after.