Yesterday was an interesting day for appointments. As many of you saw, I had therapy—something I used to undervalue but now see as absolutely necessary. Good therapy is worth its weight in gold.

 

My other appointment was with the orthopedic surgeon. For the past three years my shoulders—already bad—have gotten worse. Two months ago, the orthopedic fellow told me surgery would likely be the best solution. Yesterday was supposed to be the day to decide when it would happen.

 

Instead, I found myself having to sell the new fellow on the idea. I walked in under the impression that my case was clear: MRI damage confirmed, previous notes leaning toward surgery, and me ready to get this handled. But somehow the conversation turned into me having to convince him. That was… odd.

 

Now, I don’t want a doctor who jumps to the knife at the first chance. I’m grateful when they’re cautious. But this one seemed more hesitant than expected, running me through the usual alternatives:

 

NSAIDs. Absolutely off the table. My duodenal switch surgery years ago means NSAIDs could do catastrophic damage. I even had to explain what a duodenal switch is. Not surprising—he’s Ortho, not GI—but still.

 

Cortisone injections. Tried those. Relief lasted a month at best, then the pain stormed right back.

 

Surgery. The very option that had already been floated, and the one that made the most sense given my bone-on-bone reality.

 

 

Yes, I know the risks. Yes, I know compliance is critical. I told him flat out: I am more ready for a procedure than I’ve ever been. I’ve had major surgeries before and handled them. The surgical coordinator later reassured me that things weren’t as dire as the fellow made them sound. Standard speech: whether it’s a hangnail or open-heart surgery, they’re required to warn you that you could die.

 

I’ve had several VA surgeries, and I’ll say this: the care has been excellent—sometimes better than private systems. Even before I worked at the VA, I saw professionalism and dedication. People love to tell horror stories, but my experience has been positive. VA staff often work miracles while being understaffed, underpaid, and unfairly maligned. Veterans have specialized needs, and the VA understands those in ways civilian providers often don’t.

 

The topic of substance use came up, as it always does. I was honest, as I always am. Unlike with the plastic surgeons, this fellow didn’t immediately hit the brakes. I could see the concern flicker across his face, but at least he didn’t flat-out refuse. Opiates aren’t my thing anyway. They make me sick, and I’d rather avoid them.

 

Am I nervous about surgery? Of course. It’s major. But so was the duodenal switch, and I survived that. My sincere hope is that after the first shoulder is repaired, some of the mobility I’ve lost will return, and the pain will ease. Pain has been a relentless, cruel mistress. When NSAIDs aren’t an option and the joints are ground down, there aren’t many cards left to play.

 

Through all this, I’m thankful. For my dogs. For my mom. For my dad, who’ll help after surgery. For family—because time is finite, and you never know how much you have.