Shouldering Diabetes

I haven’t been posting as much as I would have liked this month or last as I’ve been dealing with problems in my shoulder that have been affecting everyday living and sleeping.

The first time I heard the word “musculoskeletal” was back in 2013 when I was diagnosed with a frozen shoulder. Thankfully, my frozen shoulder, once diagnosed, was resolved relatively quickly with physiotherapy. It just so happened that the physiotherapist I ended up seeing had done a thesis on musculoskeletal issues and their prevalence in people with diabetes. So, I did some research online too. Frozen shoulder, trigger fingers, carpal tunnel come up as being more common in people with diabetes again and again and again.

RESEARCH

• “If you have diabetes, you're at increased risk of various bone and joint disorders.”

• “Musculoskeletal complications are most commonly seen in patients with a longstanding history of type 1 diabetes, but they are also seen in patients with type 2 diabetes.”

• “Diabetes—Frozen shoulder occurs much more often in people with diabetes, affecting 10% to 20% of these individuals. The reason for this is not known.”

• “Whilst diabetes is widely recognized as causing significant morbidity and premature mortality due to myocardial infarction, stroke, renal failure, visual impairment and foot ulceration, it is less widely known that diabetes is associated with a number of musculoskeletal conditions.”

Image by Peggy und Marco Lachmann-Anke from Pixabay

Since then, I’ve had a serious of minor musculoskeletal ailments, however, my most recent issue has turned me into a desperate zombie who hasn’t slept through the night in over three months.

I first noticed a niggly ache in my shoulder before Christmas and booked an appointment with my physio but she had to postpone. By January, it had become so much worse by the time my rescheduled PT appointment happened that it was disrupting my sleep. I’ve also been seeing a rheumatologist for my various aching joints and a couple of weeks later at my appointment with her I had a steroid injection.

By early March, my pain had increased so much that I haven’t slept through the night since. My PT suspected an inflamed AC (acromioclavicular) joint and suggested finding a different type of specialist. I then spent two months chasing people and referrals over the phone to finally get an MRI and a musculoskeletal radiologist. I have private health insurance so my experience is in the private healthcare system. I’m at the stage in my frozen shoulder where I can’t raise my arm above shoulder height. I can’t tie my hair back, I struggle to get dressed and undressed and reaching out the car window to collect a car park ticket or pay tolls is hugely painful.

My MRI revealed that I wasn’t going insane, and that there was not only bursitis (inflammation) but also a partial tendon tear, a frozen shoulder and, because I haven't’ enough to deal with already, mild joint degenerative osteoarthritis. Since then, I’ve had an ultrasound guided steroid injection into my shoulder to ease the freezing. Next is intensive physical therapy and at home exercises to bring back motion. I’m also having a second injection into the inflamed area. My consultant would normally do both injections in the same visit but was splitting the doses to make it easier for me to manage the crazy glucose levels that steroids cause. His words were, “you’ll have a small blip instead of a massive blip”. His knowledge of glucose management was something I very much appreciated.

Amazingly, my diabetes hasn’t been giving much grief this whole time. Of course, the nights where I might’ve had a chance to sleep a little better were ruined by glucose sensor alarms. And then it’s taken 10 days to figure out how to adjust my overnight basal insulin to counteract the steroid injections. I finally got it down to zero alarms last night. Pathetic yay! :-(

So while I’m still not getting a decent night’s sleep I’m feeling positive about my outlook and that I will make it back to full arm swinging motion. And my writing.