h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Entry: The Human Shoulder - A781490
Author: Friar, the BigDawg - U158503

OK, it's not done yet. Yes, I realize tat means its going to be LONGER.

But "look at all the bones".

Anyway, it's detail city in this mongo entry, so beware.

But I would like to have some help with livening it up a bit.

I'm going to add a poem, but so far it's like watching a long movie without the intermission.

Thanks in advance for your help.

Friar

it seems to be comprehensive enough.

One condition that isn't obviously mentioned is the pitting of the shoulder socket, which leads to inflamation of the fluid sack, and seems to be fairly hard to cure. (it took me nine years to get it so it didn't flare up without obvious cause).

There's a lot of medical detail here which will go right over the heads of readers of the Edited Guide. Maybe you should concentrate on common shoulder problems, what (in simple terms) causes them, maybe precautions to prevent or minimise them, what treatments are available, that sort of thing - in other words, the shoulder as seen from the lay person's viewpoint.

Don't add a poem; and take out the substantial quotes from textbooks, which wouldn't be allowed.

My advice, for what it's worth, would be to make this into something more informative and interesting to the general reader. I am afraid that might mean doing some fairly radical surgery, but if that doesn't cause too much pain the prognosis could be a first-class addition to the Edited Guide.

Bels

xyroth - it sounds like you're describing bursitis, inflammation of the fluid sac between the humerus and glenoid. I haven't talked about the diseases of the shoulder yet, but I'm writing that bit today.
Bels - well, i totally agree about the length and depth. I wanted to include the anatomy and the major diseases of the sholder, to create a reference of sorts. Maybe this is two articles: one on the anatomy and one on the diseases. The shoulder is a complicated structure obviously so simple discussion of one or the other would naturally lead to unansweable questions if I stick to just one topic. But if I reference one with the other, maybe that will work.
That way, in the part with diseases I can write in a way easier to understand, and anyone with questions may reference the anatomy bit on its own.

The poem was just a joke.
But I may add a pratfall or two.

The references will be removed (they kinda don't make sense in that format anyway).


Friar

Just having a short skim though it (I haven't eaten yet, so I may well be back to read this properly)...

You've chosen a pretty complex joint I hated having to know the anatomy of the shoulder; rotator cuff, adductors, abductors, rotation of the scapula et al... but the vast amount of stuff which can be written on the shoulder may be too much for your average entry to hold - perhaps a University Project on this?

That way you could divide it up into a detailed yet accessible anatomy of, neurology of, diseases of, common injuries, how to examine etc, etc

But I'll be back to have another look at this Great choice for an topic

Stay ,
WD

University project would certainly afford this piece a lot more detail. There shouldn't be a table of contents in an typical guide entry, i totally realize that.

Maybe we can just edit it down to :
Mostly Harmless


Friar

If only I had that option in my second year - however, I could only answer 'true' or 'false'.....

I'm doing a rotation in Physical Medicine and Rehabilitation, so we see shoulders. Lots of shoulders.
Pretty cool

Friar

Just finished a firm on vasular surgery - so saw veins, veins and more veins with the odd lap choly for variation....

Yours sounds far more interesting

ugh I did 8 weeks of surgery in May and June. Nightmare, q3 call schedule, 12 hour days in between, not a big fan of the surgery lifestyle, love the work though, very focused.

Friar

not quite, but recurring bouts of bursitus (although I was not told the name) was a common secondary injury.

What I am talking about is where the socket gets pitted, and thus acts like sand paper. this causes any significant stress on the joint to trigger the bursitus episode.

I may be wrong, but I think it might have been called artherosclerosis of the shoulder.

to help norrow it down further, treatment methods attempted include various forms of physio, heat treatment, and multiple cortizol (or is that cortizone) injections.

The evential successfull treatment which has resulted in a lack of flare-ups for the past 6 months is near total rest of the joint for 9 years!

First, thank you folks for your input, I'm going to move this project over to the University of Life.

Second, I understand what you're saying xyroth and yuck.

It sounds like there was damage to the bone that iritated all the tendons and muscles. Helping the muscles etc., would only work in the short term then, so what you're telling me makes total sense. If there are bony changes to the humerus surgery is an option because they don't have to replace the whole shoulder. You're describing damage to the scapula (the glenoid) and the only treatment for that (that I'm aware of) is arthroscopy or possibly joint replacement.

The arthroscopy could possible remove damaged tissue that's building up, but that isn't causing your problem (in fact it's probably forming a good callous and helping reduce the pain). The only CURE would be a TSA - total shoulder replacement. Not fun, Not the end of the world, but not fun.

Please remember that heat help if the joint is not inflammed (any -itis disease), and ice helps if it is inflammed. Ice will limit your mobility though, such as it is.
continued best wishes,

Friar
ps. I hope it's not your drinkin' shoulder. . .

had the arthroscopy, and it confirmed the condition.

was told that the shoulder joint was unreplacable.

I got around the pain using strong dihydrocodine/paracetamol mix, and then learned how to not notice the pain thereby delaying the need for taking the tablets.

went from 100 tablets per month down to none at all for over a year.

not bad eh?

That's outstanding, more important than how many pills you're taking is how you feel, which is probably a lot better.

A good chonic pain clinic, with emphasis on non-narcotic therapy is great. They can teach relaxation therapies, they can help recondition muscle and train you to minimize the work your shoulder does.

Surgery on the shoulder is rough because of the proximity of the vessels. It's like the brain that way, some places just are not successfully treated.

Well, the good news is that you're feeling better. Even if your shoulder is immobilized, if everything else is better you can function.
Friar

after nine years of rest, some of the missing function is finally starting to return. only sometimes, and not very much, but any improvement is better than none.

ps you don't tell the dss because they have an all or nothing opinion about things. If you can use it on day X, then you are faking not being able to use it on day Y. not very helpfull.