Testimonials

Anita H. is a professional ultrasonographer whose medical career was interrupted by a severe Repetitive Strain Injury in 2000. What follows is the first installment of her story told in the form of her reflections upon the beginning stages of the her shoulder and arm problems as she struggled to work through it.

It all began with my shoulder hurting, kind of like an ache.  It would hurt in the evening when I was at home.  It hurt in the car while driving.  At first I ignored it, until it started really hurting to the point that I could no longer ignore it.  Awakened at night, in the middle of a restless sleep, my shoulder would hurt. Turning over in bed, I would go back to sleep, only to awake again, and turn over again.  In the beginning I did not even remember that it was waking me up, I was so tired from working so many hours. Exhausted from work, house chores, children’s schedules and trying to coordinate everything while working 50 to 60 hours a week.  This shoulder aching turned to more consistent night and evening pain.  It keeps me awake; I couldn’t find a comfortable position.  Tylenol, then Excedrin, and then Motrin, Advil, Aleve…let me see, did I leave anything out?  The pain from my shoulder was the worst, but my arm was throbbing too.

Ben, an undergraduate student nearing graduation with a degree in physiology, was chosen to work with me in the doctor’s office.  I was trying to stabilize his new practice, which had been acquired in 1999 by the vascular surgeon that I worked for, to bring the vascular ultrasound testing facility needed credibility and accuracy.  It was a huge task that I had undertaken. The process was not an event, but just that, a process.  It required that I see every patient that walked through the door of the practice, perform the appropriate testing, and then set up an appointment with the vascular surgeon so that the patient could meet the new doctor. Three medical communities were watching every step of the process through a magnifying glass, as the physician that sold the practice to my boss had had his license revoked …he would never practice medicine again.  Every eye was watching, asking questions, even the patients doubted the results of the testing that were being performed…I had my hands full.  This newly acquired practice had a cash flow problem, and I would venture to say that it was nearly 8 months before the money started to flow into the practice from the insurance company.  It was a trickle at first, and then at the end of about one year or so, it was becoming easier to buy necessary products for the office.

I had a conversation with Ben, my assistant in the office, and told him about my shoulder hurting. When I performed an ultrasound examination, my shoulder became so uncomfortable, that I wanted to stop, move the arm and shoulder and then try it again.  I was trying to focus on what was different from this job and my previous hospital employment just prior to this position. The exam table in the office I was currently working in was not adjustable. That was different.  Previously, the exam table was adjustable in height and also in positioning.  The head of the table would go 90 degrees to the table, or the feet would also do the same.  I could slant the entire exam table with the head high and the feel low, or the feet high and the head low.  The exam table could be kept flat, and raised to the level of my chest.  It was actually a stretcher type of exam table, and was very convenient, could be moved on the wheels, or locked into position.  If someone in a wheelchair came into the room, I could adjust the table to a lower height than the seat of the wheelchair, and this would allow for easy transfer to the exam table.

That was it; Ben and I both thought that if I could get a table that would adjust, it would make it easier for me to get into a comfortable position with my arm while performing an ultrasound examination.  At Ben’s suggestion, we both agreed that I should use talk to the surgeon and get a different exam table.  But how can he afford that, if he had no money coming into the practice?  He had told me how he had to take a loan from his son to pay me my salary. I felt bad.  Some time passed, and I asked him if I could swap the exam table in his exam room that had an adjustable head for the one that I had in my room, which did not adjust in any way.   It told him my shoulder was bothering me and that I thought that it would help me if I could trade tables.  He agreed to the swap.  Some time passed until Ben was able to get one of the maintenance workers to help us make the transition of the tables.  My arm continued to hurt.  The head adjustable table made it easier to get into a different position, but my arm continued to hurt.

I made an appointment and saw my primary care physician; it was around April of 2000. My primary care doctor was booked, so I accepted an appointment with her Nurse Practioner, Marianne.  “My shoulder hurts” I told her during the visit, which was focused on my sinus infection.  As her attention turned to the shoulder, and probing questions, I admitted that my whole arm hurt, but mostly the shoulder.  It was the shoulder that hurt the most. I told her how I had a conversation with Ben about what was different in this new employment from other positions that I had held.  I explained to her how we had recently changed the exam table. I thought that it helped some, but it was still very painful. After a brief exam, and more questions, “bursitis” she said.  “You have a case of bursitis.  Take Motrin, ice your shoulder, consider going to physical therapy and you need to come back if it is not feeling better.”

Physical therapy?  Me? I don’t have time for that…how would I fit that into my day.  I already had more hours of work, family, children, husband, etc..  Physical therapy?  I will talk to one of the family practice doctors sharing the office with us.  Maybe he could recommend some place near where I work.  I traveled about 60 miles to my primary care doctor, and there was no way that I was going to go there for physical therapy and work too. That was not an option.Tom was a great MD, and really believed in holistic medicine.  “Let me print the exercises for you.  You can do them at home…and if you have any questions let me know.”   He should know; he has a sports medicine clinic as part of his practice.

Finally! Fourth of July, a time that I was looking forward to spending with my husband and children, at Uncle Bob’s Vermont meadow.  My mother-in-law’s side of the family “get together” with tents, trailers, bikes, bathing suits. We just hang out.  We would be celebrating our 19th anniversary.  The best part is NO WORK.  I would float down the river in an inner tube with other folks, take a lazy stroll on a beautiful day, with clear blue skies, and fresh, clean Vermont air.  There are so many trees, the oxygen is plentiful, and easy to breath, which is especially noticeable to me with some allergies to pollens, grasses and the like.  Sleeping in a tent, relaxing, sitting, making sa’mores around the campfire at night   and looking at the stars though a 13-inch mirror telescope.  It is always a fun time and a relaxing way to spend a few days with family.  My arm is hurting, but I notice that as the days go by, it starts to feel better.  The good ole Vermont air…it was just what I needed.

First day back to work is always a reminder of how much they miss me.   The exams are piled high, many fit-ins and of course the regular schedule- already jammed packed with routine patients and those that have been squeezed in- the staff thinking that I would not notice.  The office schedule and then both hospitals were waiting. I was evaluating whether the vacation time was worth it…the price that I was paying…at this point, I did not think I would be home until after midnight.  We have all been at this spot before.  Perhaps next year, I would only take the weekend, and forget the rest of the week attached to it…it is just so difficult to catch up.  I can feel my shoulder hurting and my hand is tired from holding the transducer.  That evening, at the bedside of an older lady, my shoulder started to burn as I held my arm out in mid air suspended over the bed, while I was leaning on my right leg, left foot off the floor.  There was no room for the machine, the bed, the patient and me.  If there were just one more IV or pole in the way, I think I would not be able to delicately balance my position and hold the transducer to perform the carotid artery study.

After 18 hours, I finally close the door to the car.  I sit in the car, turn the overhead light on, put the key in the ignition, and my shoulder is throbbing.  Turning the ignition was such a strain, my hand feels week.  I open my purse, take an anti-inflammatory, gulp some water, and call home to let them know I am on my way home.  My husband answers with a half asleep “helloooo, oh, yeah, ok, see you soon.  Bye.”  I wonder if he even knows that he talked to me.  Forty-five minutes later, I key open the door, put down my purse and sweater by the front door, walk to the bedroom, strip my clothes and climb into bed.  I lie flat on my back and fall asleep as my head hits the pillow.   Suddenly, I am startled awake out of a deep sleep; my shoulder is aching like a toothache.  I rub it, cover it up with a blanket, it feels cold, and finally go back to sleep.

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