Trapezius Myalgia
Last Wednesday, I woke up with what I thought to be a crick in my neck on the left hand side. I assumed this was simply due to sleeping awkwardly and so I self medicated with some non-prescription pain relief and judicious use of a heat pad. Unfortunately, the problem has persisted and in the last 24 hours it has become much worse. I awoke this morning at about 5:00 AM and as I sat up in bed, an intense pain ran up the left side of my neck and behind my ear. It took several attempts for me to get out of bed because if I turned my head in either direction or inclined my chin, the pain would again run up the side of my neck. Sitting down, getting up and raising my arms caused similar results. While dressing, I attempted to pull a t-shirt over my head. The pain in my neck on this occasion was so severe that I yelled out loud and nearly blacked out.
Last Wednesday, I woke up with what I thought to be a crick in my neck on the left hand side. I assumed this was simply due to sleeping awkwardly and so I self medicated with some non-prescription pain relief and judicious use of a heat pad. Unfortunately, the problem has persisted and in the last 24 hours it has become much worse. I awoke this morning at about 5:00 AM and as I sat up in bed, an intense pain ran up the left side of my neck and behind my ear. It took several attempts for me to get out of bed because if I turned my head in either direction or inclined my chin, the pain would again run up the side of my neck. Sitting down, getting up and raising my arms caused similar results. While dressing, I attempted to pull a t-shirt over my head. The pain in my neck on this occasion was so severe that I yelled out loud and nearly blacked out.
Mrs P subsequently took me to Princess Royal University Hospital in Farnborough, Kent. It is not my local hospital but we decided to go there because it has both an Urgent Treatment Centre and a comprehensive Emergency Department that are both available 24/7. Furthermore, being a training hospital there are a lot more staff available. Due to traffic and the fact it took a while for me to get in and out of the car, I arrived at the UTC at 7:40 AM. Fortunately, there were only about 10 or so people in the waiting room. After checking in at reception, I was quickly seen by a triage nurse who took note of my symptoms, current medication and wider medical history. Fortunately, as this wasn’t battlefield triage, I was not shot in the head. Instead, I waited for about 90 minutes and was then seen by a doctor who was very thorough in reaching a diagnosis.
As I didn’t have a fever or persistent vomiting he ruled out meningitis, which was fine by me, as I had even considered that. Because I was in pain when raising my arms and that the pain was specific to my neck, I was concerned that it may be heart related. I suffer from heart disease and take medication for it. Thankfully, I wasn’t having a stroke. Hence the doctor concluded that I have injured my left trapezius muscle, which runs along my neck, connects to the shoulder blade and down to the top of the rib cage. This is known as Trapezius Myalgia and it is not a medical disorder or disease per se but rather a symptom of an existing underlying condition. Hence I shall be having a scan within the next three days to determine what is causing the problem with this specific muscle. IE is it a sprain, tear or something else.
I spent about two hours at the Urgent Treatment Centre and was impressed by its efficiency. I suspect that I arrived at possibly the optimal time of day. Upon returning home, I checked the National Health Service app on my phone and found that the doctor who saw me had already updated my medical history. This had details regarding my Trapezius Myalgia and a list of follow up actions. Due to lines of demarcation and ongoing changes to “business delivery”, he could not make a direct referral to the physiotherapy department at my local hospital. There is now a self referral system in place which has to be done via a specific app. Needless to say, I have now installed this app and completed the requisite questionnaire. I now await a response from the musculoskeletal (MSK) clinic at my local Hospital, Queen Mary’s in Sidcup.
The NHS in the UK tends to be very good at dealing with urgent problems and emergencies. It doesn’t always do so well with follow up clinics and long term health issue management. For example, Mrs P’s records were not migrated when a specific cardiology department database was updated a few years ago, resulting in her effectively falling off everyone’s radar for 66 weeks. I am not especially happy or confident that the ongoing move to make all major medical departments accessible apps, is going to be as successful as the Minister of Health thinks. However, for the present my immediate health concerns have been addressed. My ailment has been diagnosed and I have a supply of opiates to address the immediate pain. The next step is to determine why it happened and what can be done to effectively remedy it. No doubt that will be another blog post.
Accidents
Accidents will happen, as Elvis Costello astutely pointed out. Furthermore they often occur in the most innocuous of fashions, as I shall now tell. Myself and Mrs P were over our local park today with our two and a half year old grandson Oscar. It is located directly behind our home and has a small children’s play area as well as various adult exercise equipment. One of these items is a low, wooden ramp whose highest end is no more than eighteen inches off the ground. Oscar likes to climb on this, run to the end and jump. Naturally, he did this today when we visited. Mrs P then followed suit (at his request) and stepped off onto the soft, child safe surface. Her right knee gave way and she fell over. Despite the short distance and the soft surface, the fall was sufficient to injure her knee, as there was an audible crack. She subsequently could not get up on her own and I had to assist her so she could sit on the aforementioned ramp.
Accidents will happen, as Elvis Costello astutely pointed out. Furthermore they often occur in the most innocuous of fashions, as I shall now tell. Myself and Mrs P were over our local park today with our two and a half year old grandson Oscar. It is located directly behind our home and has a small children’s play area as well as various adult exercise equipment. One of these items is a low, wooden ramp whose highest end is no more than eighteen inches off the ground. Oscar likes to climb on this, run to the end and jump. Naturally, he did this today when we visited. Mrs P then followed suit (at his request) and stepped off onto the soft, child safe surface. Her right knee gave way and she fell over. Despite the short distance and the soft surface, the fall was sufficient to injure her knee, as there was an audible crack. She subsequently could not get up on her own and I had to assist her so she could sit on the aforementioned ramp.
Due to the swelling and the fact that she couldn’t put any weight on her right leg, I had to go to my parents house which is nearby and fetch my late mother’s wheelchair. This proved invaluable. To cut a long story short, we went to the Urgent Care Centre at our local hospital. It is not a full A&E but this is exactly the sort of injury that they deal with. The knee was x-rayed and found to have no bone injuries. However, due to the obvious damage to the soft tissue, Mrs P has been referred to the fracture clinic. In the meantime, her entire right leg from the top of the thigh to the ankle is in a splint. She cannot put weight on it and the pain is intense, even when sitting or lying down. As she cannot move, she requires assistance with visits to the toilet. At present she is taking paracetamol for pain relief but it is proving insufficient. I shall call our local GP tomorrow to see if something more robust can be prescribed. This matter is complicated by Mrs P’s heart condition.
When I reflect on this and other accidents that have befallen my family and friends over the years, I am constantly surprised by their mundane and banal nature. My mother slipped over in the bathroom in November 2019 and broke her upper right arm. She was reaching for a towel to dry her hands. The break was so bad that it had to be pinned. My father hit himself in the face with a spanner while trying to unscrew a particularly difficult engine bolt, resulting in him knocking out a tooth. This was in the seventies when tinkering with your car was an quintessential weekend ritual in suburbia. I sprained my ankle in 2002, when stepping off the curb in Great Newport Street. My foot went black within minutes and I was out of action for at least five days. All of these minor incidents seem to have disproportionate outcomes or long term aftereffects that you wouldn’t immediately associate with such low key beginnings.
Another consideration that springs to mind, is how modern homes and public spaces are far from accommodating if you are not 100% able. Something that the disabled encounter everyday. At present, Mrs P is using a wheelchair for practical reasons. When we were leaving the hospital today, the paving stones outside were in a shocking state making wheelchair use uncomfortable and dangerous. Furthermore, at home when travelling from her bed to the bathroom, the standard doorways in the UK can barely accommodate the width of a wheelchair. We are both grateful that we live in a bungalow and do not have any stairs to navigate. Then there is the issue of care, which often follows in the aftermath of an accident. Both I and Mrs P are retired so we don’t have to worry about taking time off work to look after someone. Not everyone is in such a position or has a partner or family available to help, to begin with.
It would appear that the rule of thumb associated with these sorts of accidents is that they can occur anywhere and at any time. On a personal note I feel that they often go hand-in-hand with the mantra “no good deed goes unpunished”, because such accidents frequently stem from trying to help someone else or doing some kind of favour for another. In a curious validation of this speculation about the banality of accidents, while Mrs P was waiting to be seen in the Urgent Care Centre, one of our neighbours arrived with a cut thumb that required stitches. He sustained his injury as he was ringing his son’s front door. A loose tile caused him to slip and fall into a flower pot. To add insult to injury, the entire incident was caught on his son’s CCTV which overlooks the drive. All of which makes me think there may be something in M.R. James’ short story “The Malice of Inanimate Objects”.
