Cemetery Dislocation

Bad run routing choices in a big snow storm and a little hidden ice begat a hospital adventure on icy roads, a gnarly upper body injury, a week off work and at least three times that long off cycling and running.

“Cut through the cemetery” I said to myself. “It’ll be quieter and safer” I mused … this was about 5:15 pm last Friday, February 3rd. Vancouver has had an unusually cold and snowy winter and another heavy dump of the white stuff – one that would last all weekend – had started earlier in the day. Running in fresh snow is usually very enjoyable.

Getting back to the cemetery, I was roughly 8k into a 10k run and pretty much on the home stretch. I just needed to go about a kilometer west to Boundary Road and a little bit south home. My routing choice was a traffic-choked road with headlights in my eyes until I got to my hood, or a quiet jaunt on a twisty road past a funeral home. Choosing the latter would prove to be my undoing. A few hundred meters in, as I approached the funeral home, both feet went out from under me forward on slick ice hidden by fresh snow, and the rest of me went backward and down.

As my right shoulder blade bore the entire impact, the electric-like jolt and audible crunch told me something wasn’t right. I couldn’t put any weight on my right arm to get up and was reasonably sure, at minimum, I’d suffered a dislocation. I walked up to the funeral home and through the front door. Normally closed at this time on a Friday, they were preparing for two late viewings, and so they made me as comfortable as they could with a rolled up blanket to support my arm and another around my shoulders for warmth. This was most fortunate, as a walk home of well over a kilometer in the cold and heavy falling snow would’ve been pretty miserable.

Given the horrible road conditions with the day’s snow, I expected it might be a while before I got to the hospital. They called an ambulance for me, while I did my best to left-hand text my wife and son to see if anyone could come get me. Though she was home, unbeknownst to me she was shovelling the driveway, while my son was on the other side of Burnaby. Eventually I had both of them en route to get me, along with an ambulance, or so I thought.

Turns out there was a bit of miscommunication between them, with my wife saying she’d meet them at Burnaby Hospital, thinking he was closer to me than he was. He was definitely on his way, but actually got his friend to drive him. I was very thankful for the effort, but the gripless summer tires made for slow going, and had me a little white-knuckling in places. Unfortunately, quick texts under stress can sometimes get misinterpreted and my badly misspelled left-handed messages weren’t much help either. All in all, it was probably about 6:30 or so by the time I got to the hospital.

At the Hospital

The x-ray shows my right Humerus probably an inch high and three inches forward of its normal location

Emergency was busy, but I did get prioritized fairly high, given my protruding Humerus and all. After registration and triage, I suspect it was only about 15 minutes until I was sucking on Nitrous and being cut out of my running shirts. Given that shock had worn off by this time, the agony my arm was causing made it feel like I was in the waiting room for an hour. Unable to sit forward or back, nor to put any weight on the dangling appendage, I also couldn’t risk walking around and falling on it again, either. I was sort of a hunched-over lump of kill-me-now.

I can’t recall if I’ve ever needed Nitrous before, but even if it’s short-lived, the speed with which it eases the major discomfort and relaxes you is pretty amazing. I’d say I went from despondent to not bad in about five minutes flat. While it got me through having my shirts cut off and my shoulder x-ray, it only takes you so far. At that point, I was probably doing my best to empty the tank just to stay somewhat even-keeled. Something stronger would be needed to put the shoulder back in place.

I guess if you’re in a lot of pain, laughing gas is really just bemused gas

Enter Morphine, a double-dose in fact. Once that had set in after about ten minutes, the main doctor attending me attempted to put the Humerus back in place manually. Guessing it was purely the morphine, but this really wasn’t all that uncomfortable and, in fact, pulling back and down on the arm actually felt pretty good. Unfortunately, it wasn’t budging and, after a good ten minute effort, the decision was made to put me out.

I don’t recall what they gave me, but the only time I’ve ever experienced something similar was when I had Demerol many years ago before surgery. As the second doctor introduced himself to me, I quite rapidly spun into a dizzy, delirious and thoroughly enjoyable haze. Never feeling like I was truly out, I recall asking when they were going to put my arm back and was informed that they’d already done it and it took about six minutes. Apparently, I was asking this question right on cue. It happens to almost everyone.

After another x-ray to confirm my arm was back in place, that my blood pressure and vitals were normalizing and that I could walk without falling over, I was released. All told, I left for a 10k run around 4:30 pm and got home almost exactly six hours later.

Post-hospital

I gave my neck a pretty good wrench when I went down and spent all day Saturday with something close to a migraine, and it’s still tight as of Wednesday. Finally able to kill the headache by Sunday morning, mostly I’ve been doing very little since. I couldn’t get into see my normal physio on such short notice, but did get into see someone else at the same place, Fortius Sport. They’re integrated, so everything we went through will be there for my appointment with my regular physio on Friday.

I should note that I got a lovely Polysplint from the hospital upon release as well. Mostly to immobilize the arm to remind you to not engage your shoulder much, I found its adjustability and comfort to be somewhat lacking. After trying to sleep with it for two nights I pretty much gave up. I kept my arm pretty immobilized with my Humerus close to my body all weekend and beyond, anyway.

My Polysplint hasn’t exactly been much use

I was pretty happy when on Monday, the physio suggested that I really only use the splint when going out in public, as much for notifying other people to avoid contact, as anything. Her inspection and initial treatment suggests my shoulder is in pretty good shape. We went through some massage, light range of motion exercises for home and some TENS and ice treatment. While the hospital gave me a pass off work through at least today, given the repetitive lateral mouse motion of sitting at a computer all day, the physio strongly recommended I give it the week and return to work after the holiday Monday. Who am I to argue?

Given that it’s gone back in place pretty well, this was my first shoulder dislocation at 52 and I don’t play contact sports, she seems to think repeat dislocations aren’t a big concern for me, but once you’ve done it, statistically it’s far easier to do it again.

At any rate, I’m playing it smart and want the tendons and muscles to tighten up properly. I don’t expect to test driving stick until well into next week, with a return to cycling and running some time after that, entirely dependent on how physio and progress goes over the next while.

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