Tuesday, January 27, 2009
Ouch, ouch, OUCH!!
So I was getting on the bus to work this morning, and somehow I didn’t quite lift my foot high enough for the second step. Which resulted in me falling up the steps and ending up sprawled out in the bus’s entryway, looking up at the driver. He was quite solicitous to one of the regulars on his route, asking me if I was alright. I smiled and told him I was OK as I scrambled to my feet and headed to a seat.
Except that I knew I wasn’t OK. I’d tried to put my left hand out to break the fall, but it didn’t get out there in time. Instead, my stretched-out upper arm took the brunt of the fall, resulting in a very painful shoulder. Sitting in my seat, I quickly realized that I could raise my arm only a little bit before the pain, and a feeling of impingement, stopped me. I knew there was something very wrong. Was my shoulder dislocated? Fractured? Separated? Swallowing some ibuprofen, I headed over to the emergency room.
As an employee of the hospital, I may have received care a bit more rapidly than a “civilian”. But the place wasn’t at all crowded—the whole time I was there, I was the only patient in a four-bay examining room—so perhaps I wasn’t moved ahead of someone else. After a nurse set me up with a blood pressure cuff and pulse oximeter (both of which were discarded as soon as the examination got underway), it was time for the evaluations.
A resident took my history, did some preliminary range-of-motion tests (ouch!), and informed me that I’d probably be heading off for an X-ray after he checked with the attending physician. However, when the attending came to see me, repeating some of those ROM tests and trying additional ones, he cancelled the X-ray order. It was clear that there was no fracture or dislocation, and soft tissue studies would require an MRI. Since it was possible that there was little or no serious/unhealable damage, and because nothing invasive would be done at this point, there wasn’t really a good reason to do any imaging. He did order Toradol, a strong injectable (in the butt!?!) anti-inflammatory medication. Finally, he called for a physical therapy examination.
After a moderate-length wait, the PT came in to do her evaluation. She quantified my range-of-motion limits in several axes (more ouch!), palpated for whatever it is that PTs palpate, suggested a number of exercises for the shoulder, and referred me for additional PT sessions. That regimen will start on Thursday.
As I began to put on my shirt and coat, I was increasingly aware of the difficulties this injury will produce. For one thing, simply putting on the shirt took preparation and careful attention—unable to raise my arm, I had to carefully place the bad arm in its sleeve, then fumble behind my back to locate the other sleeve. As the day progressed, these limitations became all the more apparent. Tying my shoes, washing in the shower, opening a jar, even opening a pill bottle will require accommodations to minimize the pain and discomfort.
Hopefully, this injury will resolve itself within a couple of weeks. If not, I’ll have to go back for more extensive studies, including imaging. But that’s far in the future, if it comes about at all.
This is my first experience with what is, in all likelihood, an injury to the rotator cuff. It ain’t fun. I can’t imagine how a ballplayer could continue throwing after injuring his rotator cuff, though of course those injuries are usually chronic rather than acute. Also, at first I was surprised that a fall of just a couple of feet could cause this much pain and discomfort. On reflection, though, I think it’s possible that the short distance actually made it worse, because I didn’t have the time to get my hand down to cushion the blow. My hand wasn’t scraped or bruised in the slightest, but the attempt to get it out there ended up compromising my shoulder.
Oh, you may be wondering how it is that I can type this complaint about how much my shoulder and upper arm are hurting. Well, for one thing, I’m not a touch typist. I ordinarily hunt and peck with fingers on both hands (strangely, although I’m righthanded, I use two on the left and one on the right), but for now I’m basically using just that right index finger. However, I can use the left hand a bit, as the keyboarding position is a relatively painfree one.
Now to see whether I’ll be able to get any sort of sleep tonight. And whether I can do much of anything at all tomorrow; with ordinary minor injuries, the second day is often worse than the first. Lots to look forward to, eh?
