Saturday morning, I went to the drugstore to pick up a refill for one of my pain medications, only to discover that there weren’t any refills left on it. This particular medication is the linchpin of the chemical arrangement that makes my functionality (such as it is) possible, and I was suddenly faced with the fact that I was going to run out. It being a Saturday, there was no-one at the doctor’s office to call for a new prescription (lesson being, do not refill prescriptions on Fridays), and worse, because it was technically classed as a narcotic, I’d actually have to physically show up at the office in order to get a new prescription, likely Tuesday at the soonest.

I simply did not have enough to tide me over until then.  In fact, I only had just enough to scale down in order to avoid the unpleasantness of withdrawal.  And despite my perpetrations towards weaning myself off of the pain medication a couple of months ago, I haven’t actually been anywhere near that eventual goal.  But it seems I was about to get there, just like that, in less than a day, in fact.

The pain broke through Sunday afternoon.  Monday, I contacted my doctor and found a friend to take me to the doctor’s office Tuesday morning. By then, the pain had been holding at pre-nerve ablation intensity, somewhere in the 7 to 9 region, for nearly thirty-six hours. The drive was excruciating.  The next few days weren’t much better, as I waited for the medication to build back up to a point where it got ahead of the pain again.

It is now Friday morning, and while the pain is still not back to where it was before, it’s far better than the intervening days between Tuesday and now. During those intervening days, my shoulder knifed and clawed at me with impunity, no matter the time of day or the task at hand. Sleeping and eating once again became low-frequency activities. I was virtually house-bound as well, missing classes, unable to meet my evening obligations, and on one particularly humiliating day, requiring help to change the sheets on my bed.

Suffice it to say, it’s been an illuminating three days.

First, I’m glad that such extreme pain is no longer my normal. Yes, I have pain all of the time, but it’s not so much that it forces me to keep my right arm immobile, or that I can’t find a comfortable sleeping position, or can’t concentrate on my studying for more than twenty minutes at a time. It’s not so much that I find myself at home with too little to do and too much time to do it. (Bright side, I’m caught up on my school work. Whee.)

Second, I had thought the nerve injury had been getting better with the increased strength and range of motion in the surrounding tissues. After all, the physical therapy, brace, and a maintenance pain regimen had gotten me up to a level of functionality that permitted me to take a couple of classes and manage getting to and from most of my appointments by myself. My pain level was generally quite manageable for at least the first half of the day, lulling me into a sense of undergoing gradual but observable improvement.

Well, not so much, it turns out. This past week, normal functioning – even though my bar for “normal” is set pretty low – was all but impossible. The nerve pain, the root of this injury, is still no better. It may not register as the horrifying emotional experience that it was when this all started, but by and large, the actual physical component of the pain has not changed, casting doubt on the ability of physical therapy alone to mitigate the injury itself, whatever that injury happens to be, which, of course, is still an enigma.

It’s got me reconsidering the surgical option. (Not that there would be time for that any time soon; I refuse to take myself out of play in the middle of the semester.) After all, if the postural adjustments and muscle strengthening that were supposed to help the nerve entrapment haven’t, then what else is left? My orthopedist has some good ideas, and he claims he’s had patients like me who’ve had good improvements after surgery where he files down the proximal edges of the shoulder blade, but I remain skeptical. While it’s certainly possible that would help, I’d prefer to have some visible evidence of the radiographic or ultrasound variety before he cuts me open.

It’s also just as possible that it wouldn’t help, and that putting my less-than-resilient body through such a procedure would be a grave mistake. Of the many things I’ve been forced to admit through all of this, one of the most important ones is the fact that I am not like other people. On the bell curve of injury resistance, I am out in the tail at the wrong end.

But there’s more to it than that.  Something inside me is fighting the option, not intellectually, but emotionally, and now that I’m aware of it, I’m doubting my logical-seeming reasoning. Do I have my thumb on the scale? Am I so comfortable with the way things are now that I’m loathe to change them, even if they might be improved?

It’s an odd situation, to be weighing my options while trying to accommodate for the tricks my mind likes to play on me. It’s like trying to play yourself in checkers. You already know what the other player’s strategies are, and he already knows yours. You try to play both sides fairly, but at some point you start favoring one side or another, and then that side wins. An argument with myself will fall out the same way. At some point, I will choose one side to favor and then that side will win and more likely than not, it’s the side I would have picked anyway.

Now that I think about it, a lot of my decisions probably get made that way. I think I’m objectively arguing equally for both sides, but chances are I’ve already made my decision, and the argument phase is simply a way of justifying it, to myself, and to those around me who might offer feedback. And I have to admit, I have been catching myself having these little arguments in my head a lot lately, even over silly things like when to wash my hair or what to eat for lunch. It’s as though the voice in my head that used to bully me has now turned into a petulant teenager that’s trying to get out of doing anything she doesn’t I don’t feel like doing.

I suppose the smart play would be to simply stop having these mini-debate sessions entirely. I like to think of myself as open to feedback, as willing to consider another point of view in the face of new information, but apparently my intellectual elasticity doesn’t usually translate into action.

Which means, with regards to the surgery option, that since I’ve already “decided” that I’m going to be like this for the rest of my life, any arguments about whether or not I should undergo a surgical procedure in hopes of improving it are all going to end with me deciding in favor of the side I’ve already picked, which is to leave things as they are. It took me such a long time to get used to being the way I am now that I’m unwilling to have to go back and learn how to get used to something different all over again. Surgery might make me better than I am now (and of course, “same” and “worse” are also options), but I’m still reluctant.  There might be good reasons for being reluctant, but those aren’t the reasons behind my trepidation.  What’s really going on is that I just do not want to mess with the status quo, even though the status quo isn’t all that great.

Fortunately for me, there’s no point in weighing the possibilities at the moment, since I don’t see the orthopedist again until the end of December. I used to be such a worrier, but pain and fatigue have a way of breaking you of energetically expensive and low-payoff habits. I probably should at least address the idea in some way, look up primary research, find some people to talk to, but I just don’t feel like it. But how much of that is because I rightly feel that there’s no point in opening this can of worms right now, and how much of it is petulant teenager unwilling to disrupt her little routine?

It doesn’t matter, I suppose, because whichever it is, I’ve already decided.