“We Can Hold Each Other Up”

Some Thoughts On Shoulders

Hello, friends, family, newcomers, Ladyparts readers, and those who have recently entered their email addresses into my website! Welcome to my Substack, Ladyparts.

I want to talk to you today about shoulders: mine, yours, the collective ours. We don’t really think about our shoulders all that much––I didn’t, at least––until they either start to hurt or we need one to lean on.

My left shoulder started to hurt after my second Covid vaccine in mid-March. No big deal. My right shoulder also hurt for a few days following my first Covid shot. Yours probably did, too. But with this second shot, days of pain turned into a month, then a month turned into three months, then suddenly the pain was so extreme I could not sleep at night, lift a glass of water, or reach my hand behind my back to unhook my bra. 

By June, with my shoulder now completely immobile and inflamed, I visited the office of Dr. Struan Coleman, an orthopedic surgeon who has operated on both my knee and my ex-husband’s shoulder. He’s also an old friend from college who happens to treat the knees and shoulders of major NFL players, so, you know, I trust him. I was, Struan told me that day, the third person to walk into his practice with post-vax frozen shoulder. This, apparently, is a thing, with its own acronym, SIRVA: shoulder injury related to vaccine administration.

How does SIRVA occur? The vaccine needle––not just the Covid vaccine needle, any vaccine needle––is placed too far up on the upper arm, and it pokes into the bursa instead of into the muscle, causing severe pain and inflammation. (See my MRI below.) And whom does this malady strike most? Women. Why? Because most of us born with uteri have less muscle mass than men on our upper arms.

After meeting with Dr. Coleman and scheduling the MRI above, I contacted Dr. Marko Bodor, who coined the acronym SIRVA and wrote this seminal paper on it. "Vaccinations are very safe,” he reminded me. 

As if I needed reminding. And now I remind you because the last thing I want to do by writing this public service announcement about avoiding SIRVA is to dissuade anyone from getting the vaccine. I just want women to be aware of the possibility of a shoulder injury which is easily preventable if you take the proper precautions. The key for prevention, Bodor told me, is to make sure the person administering your vaccine places three fingers sideways from the top of the shoulder (see photo below) and sticks the needle under the third finger, where it will more likely hit muscle instead of bursa. That’s it, the entire solution to the problem of SIRVA prevention. So if you’re a woman getting a booster shot, please make sure the person giving you your vaccine follows this simple three-finger protocol. You can even use your own fingers to guide them. (And thanks, Aunt Marilyn, for being my model!)

Moreover, SIRVA is rare. “The most common disabling side-effect, SIRVA,” said Bodor, “is relatively rare at 1/100,000 vaccinations and if properly diagnosed and treated can be resolved effectively in the majority of people.” Then he added, “I believe the mRNA vaccines pose a much lower risk of SIRVA than even flu shots.”

Should you find yourself unlucky like me, and you contract frozen shoulder anyway, you’ll need to visit an orthopedic surgeon like Dr. Coleman as soon as possible––time is of the essence––and get an MRI to gauge the extent and location of the damage. After that, you’ll need an ultrasound-guided cortisone shot, followed by several weeks of physical therapy. If that doesn’t work, contact Dr. Bodor. He has been working on new protocols for treatment. 

All of this, to say the least, was no fun, time consuming, expensive (most health insurance policies won’t cover PT, never mind the absurd copays of scans and shots, and yes yes yes we need to fix this!), and I wish I had known about the three-finger protocol, but again, I remind you: a few weeks of frozen shoulder––mine’s fine now––is preferable to death from Covid. I know. I had a bad case of Covid in March of 2020, and I never want to go back to those scary shallow breaths ever again. I’m also, unfortunately, one of the long-haulers, with an ongoing dysautonomia disorder for which I was recently hospitalized.

Meanwhile, I want to tell you about another shoulder: Sidney’s. Sidney, a nurse and single mother, grew up in Guyana; raised her only son in Crown Heights; and just bought a house in Queens. I know all of this because Sidney and I happened to sit next to one another in the front row of the family section of the white coat ceremony at the University at Buffalo, where her son and my daughter are starting their first year of medical school. 

“Are you here by yourself?” Sidney asked me. I nodded, hoping she wouldn’t notice the tears forming in my eyes, which were now scanning the audience of large, extended families, many of them first generation Americans, all here in great clumps to cheer on their students. “Me, too,” Sidney said, adding, “Don’t worry, we can hold each other up.” 

We can hold each other up. I loved her already. And that’s exactly what we did. When I audibly sobbed in my seat, right after my daughter finished walking across the stage to receive her white coat, Sidney put her arm around my shoulder and said, “That’s you. That’s all you. You did this. Be proud of yourself. Take a moment to appreciate your hard work.”

“No,” I said, laughing between tears, “she did that all by herself. She even once saved my life.” 

Exactly three days prior to my daughter’s white coat ceremony, I told Sidney, I’d published a memoir, Ladyparts, which opens with a horrific, bloody scene of my near death from vaginal cuff dehiscence, when my future doctor daughter had rushed me to the hospital. She wanted to call an ambulance, but I wouldn’t let her, afraid as I was, as a newly laid-off single mother on COBRA, of the hidden costs of calling one. (God bless America.) We ended up taking UberPool to the emergency room. Here’s an excerpt from that moment:

My daughter made the decision to go to medical school, I told Sidney, soon thereafter.

“That’s a wonderful story,” said Sidney, “but no child does anything completely on their own. You may have leaned on her when you were bleeding out, but she had you to lean on her whole life. I want you to own that.”

“Okay, okay,” I said, smiling at my new friend, but suddenly it was Sidney’s son turn to walk across the stage, so I rushed out into the aisle to shoot some photos of him for her. Then we held hands, shoulder to shoulder, and cried. The med school students sitting in front of us, hearing our proud sobs of joy, turned to offer us tissues.

We can hold each other up, Sidney had said: such a simple expression of interconnection, of strength in numbers, of compassion for the stranger. One that is sorely lacking from the public discourse around vaccines and masks and social distancing in the U.S.

Just imagine if we all thought like Sidney. If we, like our neighbors in New Zealand––who just shut down the entire country after one case of Covid was discovered!––believed it is our moral and ethical duty to prop one another up, to stand shoulder to shoulder, each playing our part in that giant pyramid of humankind by social distancing, masking, and getting vaccinated (minor side effects be damned), so that this ongoing scourge and the death toll from a mutating virus might finally come to an end. So that Sidney’s son and my daughter might not have to face the same unending scenes of horror their professors have had to face, day after day for a year and a half, in the hospital where they teach the next generation of doctors to uphold their Hippocratic oath and to care for those who don’t give enough of a damn about others to protect themselves, their families, their communities, or their doctors from a lethal virus.

A human pyramid, after all, is only as strong as each pair of shoulders in it. If even one person doesn’t hold their weight? The whole structure collapses.