WP 1 Biomedicine-Kelsey Bauer

Hi everybody, my name is Kelsey!

Ever since I was little, it seemed that all of my free time was poured into sports. I tried all of the little league sports as a kid, and eventually settled on the 3 sports that I would continue throughout high school; volleyball, basketball, and track. Those three sports kept me busy during the school year, and then during the summer months my time was primarily devoted to travel basketball and strength and conditioning sessions. It’s safe to say that my life, including my friends and hobbies, seemed to revolve around playing sports.

My life took a brief, but extreme, change in direction after a 55m hurdle race during my 8th grade track season. Hurdle races in Middle School remind me of toddlers learning to walk. It seems like the runners are always falling down, soon to be back on their feet and ready to conquer the next hurdle (literally), after only a few tears shed.  On the second to last hurdle of this race it was apparently my turn to take a tumble. This tumble was a little different from your average, however, and I ended up briefly dislocating my left shoulder, tearing the labrum of my shoulder and stretching out my already loose shoulder capsule.

After the fall, I went to the emergency room because my left arm began to sublux whenever I raised it. No MRI was done, and more attention was given to my scraped up knees than to my shoulder. I was given a sling and the diagnosis of a sprained left shoulder. Ice, Ibuprofen, and rest were the prescriptions. After a few weeks however, when this method of treatment did nothing to solve my continual subluxation, we sought further medical help from some of the best orthopedic surgeons around.

First, we went to U of M to see their head orthopedic surgeon. After examining my arm he gave me some hope by saying that he was confident nothing was torn, no surgery would be needed, and that after some physical therapy with his shoulder specialists I would be able to return to my everyday self in no time. After driving down to Ann Arbor for physical therapy two times per week for a month, my shoulder was no different from the first day that I met him. On my follow up appointment with him, he still did not order an MRI. He said that he was not sure what to do but would like to do more testing and studying the progress of my arm under physical therapy. He said he was not comfortable performing surgery to tighten the shoulder capsule of a 12-year-old girl with congenitally loose joints, insinuating he did not want to risk his success rates. I was turned away with no solutions, just the offer to become a study subject.

The second doctor we visited was the Cincinnati Red’s orthopedic surgeon. I was again elated after my initial visit with this doctor. He gave my arm about a two second examination and confidently proclaimed that he would be able to fix my shoulder surgically, no problem. We then scheduled an appointment to come down and have a routine MRI, followed by surgery the next day. When the time came for the MRI the radiologist asked me to put my arm in a position above my head that I was unable to do due to my continual subluxation. This apparently sparked red flags in his mind, and after the MRI, he consulted my surgeon about these concerns as well as the findings. I did in fact have a sizable tear in the posterior section of the labrum which would explain my subluxations when raising my arm in front of me. These findings however, did not explain why I also subluxed raising my arm to the side, as that part of the labrum was still in tact. Even though the doctor had already seen all of the positions in which my shoulder subluxed during the initial visit, this time he decided to cancel my surgery and again I was turned away with no alternatives. The radiologist and surgeon believed that the nerves in my arm were somehow too irritated to function correctly and were creating a neuromuscular response so that whenever my arm moved, the nerves fired, pulling my arm out of socket in even the healthy areas of the labrum. They feared that, after surgery, if this nerve problem were not resolved, all of the work to repair my labrum/capsule would be ruined.

At this point, my faith in biomedicine was dwindling. I didn’t see how doctors could just leave me with no hope or alternatives. Now I was not only unable to play sports, but I was also unable to use my arm normally.

After this second denial, I took a month to solely rest my arm and figure out where to go from here. When I started physical therapy again, it seemed as though this rest had done the trick. While my arm still dislocated when raised forward, it remained for the most part in the correct position when raised in directions that did not put pressure on my damaged labrum. With this new hope, we found a local orthopedic surgeon and gave it one last attempt. This surgeon, while admitting it would be difficult to promise 100% effective and lasting results for a 12 year old girl with congenitally loose joints, was confident he could produce results that were better than the current state I was in. So, on December 7th, 2010 I underwent surgery for a labral repair and capsular shift. I am happy to say that this surgeon did give me a 100% effective result. I was able to return to sports by May of 2010, continued to play year round all throughout high school, and still have full use of my affected arm today with no pain or lasting damage.

My biggest critique of the biomedical system from this experience is that it was very inflexible. The first two surgeons that I visited seemed to expect me to fit in a box for the category determined by my diagnosis. When I did not perfectly fit in that box, they did not try to provide me with alternative solutions. Instead of taking on a challenge with a less than 100% chance of success, they gave up, keeping up their surgical success rates, but losing the confidence of a young girl seeking their help. I believe that because this system is so evidence and concrete knowledge based, anything that hasn’t been directly tested or studied is a threat. With that being said, biomedicine ultimately gave me my positive results and I don’t know if I would have gotten those results using another medical system. Throughout this process I did not try any complementary medical systems, although acupuncture and even hypnotism were suggested by some of the physical therapists I encountered. Obviously, these medical techniques are being incorporated into the biomedical system, which I think will have beneficial results for future patients.

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