Inability to intubate because of rotator cuff injury

[cyanide12345678]

My wife and i have been doing some traveling, been hauling around a 33 lb child for hours. Ended up with one hell of a sprain/strain/maybe even partial tear of my rotator cuff. Currently barely able to flex, abduct, and externally rotate my L shoulder, excruciating pain with those movements.

Have to work in 2 days, really starting to doubt if i could intubate, it’s my arm that holds the mac blade. So ibuprofen, Tylenol, and suck it up and hope i don’t have to intubate or just hope adrenaline takes over? Or contact my medical director? I work single coverage so there’s that. It seems like such a silly thing to be unable to work for 😂😂😂 i would literally feel embarrassed telling my medical director 😂😂 i can work and see every other kind of patient but i just don’t think i will physically be able to intubate.

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[Birdstrike]

See Ortho; get cortisone shot and PT.

Hopefully you’re back to full function after this.

If not, the rotator cuff surgery.

Hopefully you’d be back to full function after this.

If no relief, still unable to intubate, fill claim with your own occupation disability policy. Then collect check for disability while doing either no work, or some other type of work not in EM, that doesn’t require intubation, eg, urgent care, teaching, consulting, non-clinical, non-medical.

 

[Birdstrike]

I know an EM physician who was able “retire” while young due to the “disability” of having very dry eyes. No joke. Sjogren’s, and dry eyes made it “dangerous” to intubate due to being unable to see the vocal cords during intubations while having a Sjorgren’s flare. No joke. Full ride on private own-occ disability policy.

 

[cyanide12345678]

See Ortho; get cortisone shot and PT.

Hopefully you’re back to full function after this.

If not, the rotator cuff surgery.

Hopefully you’d be back to full function after this.

If no relief, still unable to intubate, fill claim with your own occupation disability policy. Then collect check for disability while doing either no work, or some other type of work not in EM, that doesn’t require intubation, eg, urgent care, teaching, consulting, non-clinical, non-medical.

Principal insurance will not like your response birdstrike.

I’m personally guessing I’ll be at full function in 7-10 days of letting it heal. Even ordered a freaking sling on Amazon just now.

Yesterday i only had mild pain with lifting the arm above 90 degrees. But being at magic kingdom yesterday with a toddler who often wanted to be held up didn’t exactly help 😂

Lesson learned - if it hurts a little, don’t push it 😂

 

[Groove]

My wife and i have been doing some traveling, been hauling around a 33 lb child for hours. Ended up with one hell of a sprain/strain/maybe even partial tear of my rotator cuff. Currently barely able to flex, abduct, and externally rotate my L shoulder, excruciating pain with those movements.

Have to work in 2 days, really starting to doubt if i could intubate, it’s my arm that holds the mac blade. So ibuprofen, Tylenol, and suck it up and hope i don’t have to intubate or just hope adrenaline takes over? Or contact my medical director? I work single coverage so there’s that. It seems like such a silly thing to be unable to work for 😂😂😂 i would literally feel embarrassed telling my medical director 😂😂 i can work and see every other kind of patient but i just don’t think i will physically be able to intubate.

Likely not a rotator cuff tear from the activities your describing. Both my shoulders will flare up every year or two from the gym and I go see a local orthopod who gives me a depomedrol injection and it's like magic. I don't think I'd call in for that. It would be easier if you were double coverage but honestly I'd probably just suck it up and tube the pt and pop 800mg ibuprofen afterwards. You'll prob find yourself feeling better in a few days anyway. Alternatively, you could have RT do it with glidescope. If you've got hyperangulated blade, I don't really need to lift much at all. It's only when I'm using a normal blade.

I know an EM physician who was able “retire” while young due to the “disability” of having very dry eyes. No joke. Sjogren’s, and dry eyes made it “dangerous” to intubate due to being unable to see the vocal cords during intubations while having a Sjorgren’s flare. No joke. Full ride on private own-occ disability policy.

Interestingly enough the most common disability that most docs cash in on per my insurance agent is back pain.

 

[RustedFox]

I know an EM physician who was able “retire” while young due to the “disability” of having very dry eyes. No joke. Sjogren’s, and dry eyes made it “dangerous” to intubate due to being unable to see the vocal cords during intubations while having a Sjorgren’s flare. No joke. Full ride on private own-occ disability policy.

I need a scam like this.

 

[oldtown]

I know an EM physician who was able “retire” while young due to the “disability” of having very dry eyes. No joke. Sjogren’s, and dry eyes made it “dangerous” to intubate due to being unable to see the vocal cords during intubations while having a Sjorgren’s flare. No joke. Full ride on private own-occ disability policy.

That’s living the dream right there.

 

[Birdstrike]

I have a severe left wrist tendonitis. 3 of my tendons get chronically painful and show severe calcific tendonitis on x-ray, so much so that my ortho was laughing and guffawing in childlike delight when he saw the x-ray and showed me. It definitely affects my work since the Interventional pain injections I do require tremendous precision with both hands. Putting a needle a millimeter from the cervical spinal cord isn't something you want to do, when you suddenly have a sharp pain that causes you to flinch. So far, wrist exercises, multiple steroid injections and nsaids have kept it tolerable. However, it's hurting right now as I type this. The next step would be surgery. And if that fails, what next....?

If I still worked EM shifts, it would be no less of a problem. Since I'm right handed, my left hand is my laryngoscope hand and that exact motion, radial deviation of the hand at the wrist is what causes the most severe pain.

I'm the type that likes to keep busy and work, which is why I've been powering through this for a few years, already.

 

[Birdstrike]

...Here's the interesting thing. I had an individual, private disability policy I bought during my pain fellowship, so if I was injured in fellowship, I'd be covered at an attending salary, NOT at a house-staff salary. I kept this policy even when I first started as a Pain attending and it covers 60% of my salary if I'm disabled. Then, I got a group policy with my first and current job, which also covers 60% of my salary, if disabled. The kicker is, they DON'T cancel out, since the one was a private, individual policy, in place prior to my group policy.

So, if I'm ever disabled, which I do not want to happen, I actually get 120% of my current salary.

 

[VA Hopeful Dr]

...Here's the interesting thing. I had an individual, private disability policy I bought during my pain fellowship, so if I was injured in fellowship, I'd be covered at an attending salary, NOT at a house-staff salary. I kept this policy even when I first started as a Pain attending and it covers 60% of my salary if I'm disabled. Then, I got a group policy with my first and current job, which also covers 60% of my salary, if disabled. The kicker is, they DON'T cancel out, since the one was a private, individual policy, in place prior to my group policy.

So, if I'm ever disabled, which I do not want to happen, I actually get 120% of my current salary.

I did the same. I love the fact that since private policies are paid with post tax money the benefit is not taxed.

 

[Franzd'Epinay]

With two days' notice, why not put out some feelers to see if you can trade shifts with someone else?

 

[Birdstrike]

Principal insurance will not like your response birdstrike.

I’m personally guessing I’ll be at full function in 7-10 days of letting it heal. Even ordered a freaking sling on Amazon just now.

Yesterday i only had mild pain with lifting the arm above 90 degrees. But being at magic kingdom yesterday with a toddler who often wanted to be held up didn’t exactly help 😂

Lesson learned - if it hurts a little, don’t push it 😂

Btw, I've also had rotator cuff tendonitis in both shoulders. Each time, 40mg of kenalog with some lidocaine, posteriorly under the acromion had a magical affect within 24 hours. It's a super easy injection that any M.D. or P.A. can do. Either 40mg kenalog, 80 mg depomedrol or 6 mg of betamethasone with 2 or 3 cc of 1% lidocaine. Easy peasy.

 

[Groove]

...Here's the interesting thing. I had an individual, private disability policy I bought during my pain fellowship, so if I was injured in fellowship, I'd be covered at an attending salary, NOT at a house-staff salary. I kept this policy even when I first started as a Pain attending and it covers 60% of my salary if I'm disabled. Then, I got a group policy with my first and current job, which also covers 60% of my salary, if disabled. The kicker is, they DON'T cancel out, since the one was a private, individual policy, in place prior to my group policy.

So, if I'm ever disabled, which I do not want to happen, I actually get 120% of my current salary.

Man, I think I'd let someone play whack a mole on my wrist, file for your disability and throw an early retirement party. Meanwhile, I've got the mildest diabetic neuropathy pt's in the ED on disability not to mention the fibromyalgia and "gastroparetic" aka hyperemesis cannabinoid pts on disability.

 

[Birdstrike]

Man, I think I'd let someone play whack a mole on my wrist, file for your disability and throw an early retirement party. Meanwhile, I've got the mildest diabetic neuropathy pt's in the ED on disability not to mention the fibromyalgia and "gastroparetic" aka hyperemesis cannabinoid pts on disability.

Lol

 

[bravotwozero]

Man, I think I'd let someone play whack a mole on my wrist, file for your disability and throw an early retirement party. Meanwhile, I've got the mildest diabetic neuropathy pt's in the ED on disability not to mention the fibromyalgia and "gastroparetic" aka hyperemesis cannabinoid pts on disability.

‘I have a disability because I make myself throw up by smoking marijuana’…

W T F

 

[Franzd'Epinay]

I know an EM physician who was able “retire” while young due to the “disability” of having very dry eyes. No joke. Sjogren’s, and dry eyes made it “dangerous” to intubate due to being unable to see the vocal cords during intubations while having a Sjorgren’s flare. No joke. Full ride on private own-occ disability policy.

I wonder if there's more to it than that. I would think that with a documented legit autoimmune disorder you could build a solid case for severe fatigue/myalgias/arthralgias affecting your ability to consistently work.

 

[HemorrhagicShock]

There has to be more than that. These disability carriers will go to the ends of the earth to ensure they don't have to pay out a lifetime's worth of income. I've even heard stories of them hiring private investigators to ensure that you're not bluffing when it comes to how you conduct yourself in public in your free time (i.e. performing activities of reasonable similarity/ability to the specialty-specific tasks that one states they cannot perform).

 

[NYEMMED]

My wife and i have been doing some traveling, been hauling around a 33 lb child for hours. Ended up with one hell of a sprain/strain/maybe even partial tear of my rotator cuff. Currently barely able to flex, abduct, and externally rotate my L shoulder, excruciating pain with those movements.

Have to work in 2 days, really starting to doubt if i could intubate, it’s my arm that holds the mac blade. So ibuprofen, Tylenol, and suck it up and hope i don’t have to intubate or just hope adrenaline takes over? Or contact my medical director? I work single coverage so there’s that. It seems like such a silly thing to be unable to work for 😂😂😂 i would literally feel embarrassed telling my medical director 😂😂 i can work and see every other kind of patient but i just don’t think i will physically be able to intubate.

Use a glidescope? Requires minimal movement of camera hand

 

[Groove]

There has to be more than that. These disability carriers will go to the ends of the earth to ensure they don't have to pay out a lifetime's worth of income. I've even heard stories of them hiring private investigators to ensure that you're not bluffing when it comes to how you conduct yourself in public in your free time (i.e. performing activities of reasonable similarity/ability to the specialty-specific tasks that one states they cannot perform).

Legit? Was this a physician? I can't imagine there's a high rate of abuse with disability insurance among physicians. Although most docs are responsible enough (one should hope) to get the insurance, I can't imagine there's a high percentage of us that actually use it and/or abuse it. Most docs push themselves way past the point of reason and would abuse our bodies to continue to practice. I'd be curious what the actual percentage of disability claims are for physicians broken down by age/specialty. Then again, most docs probably back off the insurance as they near 65 and amass reasonable retirement assets.

 

[Arch Guillotti]

Get the shot

 

[miacomet]

Using the glidescope takes a lot less strength....

 

[BoardingDoc]

... posteriorly under the acromion ... It's a super easy injection that any M.D. or P.A. can do.

Says the interventional pain specialist.

To be clear, I'm sure you are absolutely correct that it's an easy procedure that can be learned in basically no time at all. I'm just saying that if I had this issue with my rotator cuff, I'd be going to see you in lieu of walking one of my PAs through a youtube video 5 minutes before they jab me in the ED.