I started this post early, finished it late, but the sentiment remains the same.
3 months, 3 weeks, and 3 days ago, I dislocated my shoulder, and turned my world upside down.
I discuss a traumatic injury in this post.
The original injury was 5 days earlier, when I went to let one of our dogs out at 4 in the morning, half asleep. As I was going down the stairs, I missed the last step or two, grabbed the railing with my left arm, and yanked it out of its socket as I fell. The impact on the floor knocked it back in, but it was several minutes before I could move my arm gingerly forward. My wife rushed me to the ER, where the X-Rays... showed no damage. They discharged me, and told me to see my primary physician or an orthopedic specialist if I noticed it was getting worse or not improving.
Over the course of the next few days, it seemed to mostly be doing fine. Occasionally as I'd reach to shut the car door or for something in an overhead cabinet, I'd have a sharp pain reminiscent of what I experienced in the fall, but it would immediately correct itself. (I later learned I was repeatedly sublocating my shoulder.)
Late in the week, I started a solo vacation to the Black Hills.
On my first morning in Custer, I had a leisurely breakfast, a short walk, and a trip to the grocery store, conveniently across the street from my AirBnB. I read for a while, and then decided to go visit one of the local lakes my grandfather used to take me to as a kid.
And that's when it happened.
I was reaching out to the wall to support myself while putting on one of my boots, and my left shoulder completely dropped out of the socket. The pain was so intense I fell to the floor, and found myself unable to get up due to the amount of pain I was experiencing.
Worse: I was alone, and couldn't find my phone.
I spent 20 minutes searching.
I'd move a little, rotating my body on the floor or ooching around the floor towards a potential location of my phone. Each movement would bring a new round of pain, and I'd have to stop and breathe through it before starting again. At a certain point, I was fully 180 degrees from my original position, and my right hand just managed to brush my phone, which must have fallen to the floor when I fell, and fallen to my left side. Because I couldn't move my left arm, I'd not been able to reach it until that moment.
I tried calling my wife, but she wasn't responding. I then tried my oldest son, who still lives with us, and he answered immediately, and brought his phone up to Jen. I didn't know what to do, and realized as I talked to her I was going to need to call emergency services.
What felt like an eternity later, but which was more likely only 5-10 minutes, paramedics came. The lead, who I'll call Shawna here, sat down next to me, got me to tell her what happened, and then took a ginger look at it. Her first response was, "I'm not going to lie, this is going to hurt. A lot."
She had her partner call for more assistance, and ended up getting her supervisor and her class of trainees in, and suddenly the place was full of activity. The paramedics shifted a draw sheet under me, so that they would be able to lift me up onto the waiting stretcher. They got me hooked up with an IV, and gave me Fentanyl. "It won't make the pain go away, but it will make it so you don't care," Shawna said.
She was wrong.
The pain as they lifted me onto the stretcher was so bad, I screamed and almost blacked out.
From there, they wheeled me into the ambulance, and rushed me to the ER. Each pothole or bump elicited a scream from me.
Where they needed to transfer me from the ambulance stretcher to an ER mobile bed, and I had to go through the whole thing again.
They cut my shirt and sweater off, while they waited for staff to clear the trauma room, and then wheeled me into that area. The main reason for moving me into the trauma room was due to the fact it could accommodate a portable X-Ray, which they brought in about 20 minutes later. The first two X-Rays could be done with minimal discomfort, but the final was going to require moving my arm away from my body, which caused a lot of pain. Fortunately, they were able to get a good shot before I was unable to hold the position any longer, and turned it over to the doctor.
I waited in that room for another 2 hours.
Let that sink in.
Twice during this period, they came in and gave me Fentanyl. In neither case did it have any effect. I could feel it, and it hurt. A lot. So much that I was periodically moaning, and occasionally screaming. (Fentanyl has a really short period of affect, too. Twice in two hours meant I spent the majority of that time with absolutely nothing to help the pain.)
While I was waiting, my wife arranged for my dad to come pick her up, and then they started driving across the state.
Finally, over three hours after the injury, the doctor came in to reposition my shoulder. This started with giving me Valium, to help me relax, as my entire arm, hell, my entire body, had been tensed up this entire time, trying to stabilize my arm in a position that minimized the pain.
This was the first time I'd felt relief since the injury.
They followed this with a sedative, and the next thing I knew, I heard somebody talking on my phone with my wife, and realized my pain was down from a 9 to a 4 or 5 out of 10, and my arm was now in a sling.
My wife and dad were on their way, but it'd be another 5 hours before they arrived to pick me up and get me to the AirBnB, and, the next day, home.
I was told to see an orthopedic specialist at the earliest possible convenience, and was able to get in the following Tuesday. The X-Rays they took confirmed the shoulder was back in the socket, but I had a Hill-Sachs lesion, which is when a portion of the ball portion of the humerus fractures; this likely happened due to all the moving around on the floor I did trying to find my phone. They ordered an MRI to see if there was any tearing of the rotator cuff, which happened a week after my visit. I was lucky; the MRI showed the rotator cuff intact, which meant no need for surgery, and that I could start physical therapy immediately.
Because of the severity of my dislocation, and the length of time it took before they reduced it, I was told I'd need a sling for 6-8 weeks, and that my PT would be very gradual, and likely go for 3-6 months.
The impact was immediate.
My job requires a lot of communication, and some occasional software development. Because I'm not at an office, my communication is largely via email or chat applications — which are of course keyboard-centric. Essentially, I'm at a keyboard day-in, day-out, and have optimized how I work around this fact.
And with only one hand available, this was suddenly non-viable.
My first week back to work ended up being primarily research on accessibility on Linux (I use a Linux operating system). I eventually found a tool called numen, which uses a Large Language Model for purposes of voice transcription and voice control of common tasks on the computer. (This is the first "AI" tool I've actually appreciated!) Because I have optimized my desktop to be keyboard-centric, this tooling allowed me to use my voice to perform a lot of common operations (such as opening applications, switching windows and workspaces, etc.), as well as do voice transcription when I needed to "type". (I did a lot of customization to make it work for me, but all the functionality I needed WAS present, thankfully!) It's not perfect, to say the least; sometimes what it "recognized" from my voice was absolute gibberish. But it allowed me to work, even if only at half capacity.
Outside of work, I found myself constantly frustrated by the little things. For weeks, I couldn't shower on my own, and even once I could, I still needed help drying off. I couldn't put my hair back, put my CPAP mask on, buckle my belt, or get some of my shirts on. I couldn't carry things around the house easily, as I needed my right hand for balance when I was going up or down stairs. I couldn't shut car doors, or buckle my seat belt.
My relaxation activity, drawing, was even curtailed. While it wasn't my dominant hand that was affected, it still meant that I couldn't hold my tiles to keep them from moving, and taping them down was frustrating as I like to move the paper around as I draw.
I feel really blessed to have the caring, supportive family I do. Jen and the kids were absolute stars during this time, and completely supportive even on my worst days.
At the six week mark, I was given the go ahead to wean off my sling.
This gave me the ability to type again, though I found that I'd get uncomfortable with it off after an hour or two. But it was largely at this point that things started to get better. The ability to move my arm freely meant that I started to rebuild and strengthen muscles. While I still didn't have full range of motion or strength, these got better day by day. I was able to work, able to draw, able to help cook.
It's the little things that make a huge difference psychologically.
I'm still doing PT twice a week.
We've gone from the therapist moving my arm for me, to using aids (sticks, the wall, pulleys), to adding weights and bearing body weight. The therapist changes things up every week or two, giving me time to get comfortable with the new movements or weights. I've gone from twice daily home exercises that take a few minutes, to twice daily sessions of 15-30 minutes each. My initial weight limit was a pound; I'm now up to 5 pounds for many of my exercises.
The crazy part is that I'm now stronger than I've been in 2 decades, possibly ever.
And simultaneously, I still encounter activities regularly that I either don't feel strong enough or flexible enough to do. Even flexing my arm is often uncomfortable.
And yet: I can drive comfortably, get things out of and put things in overhead cupboards easily, even carry our Boston Terrier one-armed with my left arm. I do planks daily — which is not insubstantial, considering my weight. (I've actually lost weight since I started doing PT, despite putting on new muscle!) This past week, I mowed the lawn, did edging, and used loppers to take down some unwanted bushes.
The gradual approach has worked, and I can see a future where it becomes maintenance, instead of solely returning me to stability.
At my 12-week check-up with the orthopedic specialist, he cleared me to resume normal movement. I was told to continue working with my PT as needed, and my therapist and I agreed I still have some work to do.
My goal currently with PT is to get to a point where I can do some projects around the house I'd been planning earlier this year: new shelving for our closet, a workbench for the garage.
A step at a time, I'll get there.
With all the focus on my shoulder, I neglected something: in my original fall, I'd also hit my knee.
I thought at the time it was just a bruise, but a few weeks ago, I realized the pain has never gone away. In fact, getting up from sitting, getting off the floor (which happens every day, as I have floor exercises from PT), and going up and down stairs each cause it to hurt.
I finally visited the orthopedic specialist about it, and the suspicion is that it's a torn meniscus. My insurance won't authorize an MRI to confirm the diagnosis until I have PT... so I'll be having to juggle PT for my shoulder with PT for my knee in the coming weeks. In the meantime, I'm taking the stairs one at a time. And since I can now support myself with my left shoulder, I'm using both arms to help me rise from seated and floor positions, which is helping as well.
I'd like to be at a point where I can just do... what I want to do, without some part of my body hurting.
I turned 50 this year.
It's been hard.
I was already thinking about where I am in my life, and what changes I might want to make. The most urgent one is my health; I know I'm overweight, and I've not been doing much physical activity in years now. I have bad eating habits, which doesn't help. (Thanks, AuDHD, for disordered eating!)
The injury was both a wake up call, and a call to action.
Getting myself to form a new habit by myself is hard.
I know they say you should get an exercise buddy to help hold you accountable. My wife and I have tried, but we find it hard to hold each other accountable when doing things like this, and our abilities are very different, meaning we often can't do things like exercise together. And I have very few friends, as I work from home, and haven't done much to form community; the few I have have busy schedules.
Seeing a PT multiple times a week, though, has helped me form some good habits, as I have somebody holding me accountable. I exercise every morning just before starting work, and then again when I end my day. (During the early weeks of PT, I had exercises I was doing every 2 hours, to prevent joint locks!) The result has been that I've had more energy, I've lost weight, and I find I have more focus.
I still have occasional nightmares about the experience. I've never felt pain like that, at least, not without blacking out, and the experience has left its mark. I find myself being careful going down stairs, and even though I'm gaining confidence in the strength I've built, I am often cautious when performing movement that falls outside the range of my exercises.
But little by little, it gets better.