OH. I’M NOT INSANE.

In the room, he told me he did not think a pinched nerve was the most likely primary explanation. The written note I would later read still listed cervical radiculopathy as the primary diagnosis.

Could nerves still be involved in some of what I feel?

Maybe.

We don’t know yet.

The MRIs are still coming.

But his working assessment was more centered around the scapular region.

The levator scapulae.

Scapular dyskinesis.

Scapulothoracic bursitis — which the written record would document as a diagnosis.

Muscular tightening.

And yes, I knew my levator scapulae had been angry for a long time.

I have spent enough time living inside this body to know where that particular asshole lives.

What had changed lately was everything around the rest of the scapula joining the uprising.

I had also wondered for some time whether my scapula was moving incorrectly.

I usually called it a winged scapula because that was the closest non-medical description I had.

That was my observation.

Not a diagnosis.

Now I had a clinician identifying scapular dyskinesis during the examination, while the written record documented scapulothoracic bursitis of the right shoulder.

That distinction matters.

I also explained my working theory.

Not as:

Here is what is medically wrong with me.

More like:

Here is what I think might be happening. Tell me where this falls apart.

My thought has been that the instability and myofascial issues may be creating a situation where muscles are constantly trying to stabilize things, tightening and locking down, and potentially contributing to some of the other symptoms downstream.

He didn't roll his eyes.

He didn't interrupt me.

He didn't remind me that I wasn't a doctor.

He listened.

Considered it.

Then gave me his opinion.

That is literally all I have been asking for.

He left to consult with the doctor.

Then came back.

No major change in the working assessment.

We need the MRIs.

Then we talk again.

Perfect.

That is how a working diagnosis is supposed to work.

Working.

Not final.

Not carved into stone.

Here is what we think based on what we know today.

Now let’s collect more information.

This part deserves its own section because I had just gone to pain management asking essentially the same question:

What do I do while we figure this out?

Because I understand that sustainable treatment takes time.

I understand imaging takes time.

Physical therapy takes time.

Strengthening takes time.

Figuring out a complicated body takes time.

The PA prescribed Journavx for pain.

He sent a referral for physical therapy.

And then he gave me an injection behind my scapula aimed at the area of suspected inflammation.

Right in that sucker.

Or technically behind that sucker.

Whatever.

For once there was both:

Here is what we are investigating.

And:

Here is something we can try now.

Thank you.

That is all I wanted.

We got out to the truck.

My scapular area had been injected.

Rob looked at this situation and apparently saw opportunity.

Now I could sit at my computer and work while it was numb.

Sir.

I love this man.

But my body had another memo.

I was exhausted.

Not regular tired.

The kind of tired where you know sleep exists conceptually but your brain is no longer qualified to participate in higher-level operations.

I needed a nap.

Desperately.

I did not get one.

Because despite owing myself nearly twelve hours of sleep, my pain would not let my brain shut down.

Which feels like a particularly cruel system failure.

Body: We require sleep.

Pain: Request denied.

The injection did help the scapular area somewhat.

Not dramatically.

My overall pain was still a ten.

The scapular area dropped to around a nine.

And apparently that one-point reduction was enough for my brain to begin noticing every other member of the right-side pain department.

My forearm.

My tricep.

My armpit.

The bottom of my scapula.

Sciatica.

My calf.

Even the top of my right foot.

None of those were necessarily new.

They just became louder once the scapula stopped screaming over everyone else.

The best description I could come up with was a ping-pong ball.

My entire right side seemed to stay around an eight-and-a-half or nine while some imaginary pain ball bounced from location to location deciding which one would register as MAX for a while.

Forearm.

Calf.

Foot.

Scapula.

Sciatica.

Sometimes for minutes.

Sometimes longer.

Then somewhere else would take over.

At one point I actually wanted the scapular solo back.

At least I knew that song.