Friday, April 28, 2017

Patience with injury

I’ve discovered that my patience with an injury to me is almost non-existent.  On March 8th, we were happily hiking with friends in the local Columbia Gorge, where it tends to be easy to get multiple thousands of feet of elevation in, in a reasonable hike.  We were headed back down the trail, when I managed to lose my balance and do a face-first dive into some rocks.  When I stopped, I became acutely aware that while I hadn’t smashed my face, something was very wrong.  I’m not sure if it was the searing pain or what, but I became aware that I’d likely dislocated my right shoulder.

Jay was able to remove my backpack, somehow, and began to wonder how he’d stabilize my arm for the couple of miles that we had left to return to the cars.  I decided to try to sit up, and as I did so, my shoulder popped back into place!  I still remember the wave of relief that washed over me.  The extreme pain had disappeared, and left behind extreme apprehension of a reoccurrence.  In addition, I discovered that not ALL of the pain had disappeared.  There still was quite a bit, and my right arm wasn’t exactly mobile.  I descended the trail with Jay carrying both of our backpacks, Dyanne carrying my 2nd pole, and with my right arm at my side.  When we finished the rest of the descent, I finally remembered that I could use my jacket as a sling, and put my right arm inside of my jacket and zipped it up.  That made me much more comfortable.  When we went by a patch of snow, Gary suggested that we make an ice pack.  Mark whipped out a zip-lock bag, and someone filled it with snow, and that was placed inside my jacket on my shoulder. 

After dumping off the crew at our carpool location, Jay and I went on to urgent care, where they took x-rays, told me that I’d not broken anything, gave me a sling, and sent me on my way.

I found out that the pain was lessened by sometimes hanging my arm at my side, so I did that.  Since it was my dominant arm, I re-discovered how useful that arm and hand tends to be in daily life, and how useful having a shoulder is, as well.  Putting on or taking off *any* clothes or shoes; brushing teeth, flossing; eating; closing car doors; putting on seat belts; etc.  I was happy that within a week I’d gained some use of my arm. 

And then, I finally got to see an orthopedic guy.  He broke the news to me that I did, in fact, have a broken bone (a little chip off of the glenoid – part of the socket that head of the upper arm bone (humerus) sits in), and that I also had a dent in the humerus head (also known as a Hill-Sachs lesion), and that I’d likely have to have surgery to fix those things resulting in many months of rehab.  But the good news, he thought, was that everything else seemed to be ok, but just to check, he sent me off to have an MRI and gave me some exercises to do.  The MRI wasn’t able to happen until a while later, so about 3 weeks after the accident, I learned that I also had a little tear in one of my rotator cuff muscles, but the suggestion was that that was no big deal, as it would heal.  I was referred to a surgeon and after a lot of miscommunication, finally got to see one, yesterday. 

By now, with help from my physical therapist who is also a climbing friend, my shoulder was starting to feel MUCH better, my range of motion was good, and I was getting stronger.  She kept telling me that I wasn’t ready to climb, though, and that I needed to have patience – these things take a while to heal.  I was still teaching mountaineering, and, last weekend, unthinkingly started digging with my ice-axe and noticed that I could feel my shoulder.  That made me realize that it wasn’t quite ready for prime time, but I still was under the illusion that just another week or so, and I’d be able to climb, again.

Anyway, it was with this mindset that I saw the surgeon, who specializes in shoulders.  She listened to me tell her what I do, and that it is important that it not re-occur, she felt my shoulder, and had me do a number of things, and then we looked at the x-rays and MRIs, together, while she explained to me what she saw.  She thought that the bones all looked very good, that the little dent was not too concerning because of how small it is, and that the little chip was so tiny, that it, too, did not merit surgery.  She pointed out that just going in there, moving around the muscle to try to find that little chip, which is so small that she wouldn’t even be able to put a screw in it, would cause way more damage than currently existed.  When we looked at the MRIs, she showed me that even though my humerus head wasn’t broken, it did get badly “shaken up” and that the blood was rushing in there to try to fix the damage.  And she showed me all of the damage that the various muscles had, but that, given what happened, that I really lucked out.  The damage was quite minimal.  However, it WAS damaged.  And. . . that damage takes a while to heal.  When I told her what I’d done with the digging, she cringed.  When, in conversation, I waved my arm back, she cringed, again.  She told me that I was doing too much, too fast.  When I told her that I thought that the bone would heal in what, two weeks or so, so that by now, 7 weeks later, surely it was fine?, she cringed, yet again, and told me no – it takes a long time.  That, really, while it should all heal with rest, if I do too much, too fast, that I’ll cause it to take longer to heal in the long run.  When I pressed her for how much longer I should expect it to take, she said at *least* another 6 weeks.  I can’t remember what I said, exactly, but I happened to mention “a year”, and when I did, she nodded her head and said, “yes, that is typically how long it takes for it to be all better”. . .

So, the good news is. . . it *should* all heal, and it *should* all heal without surgery.  And I don’t know what in the heck I did, yesterday, but I seem to have delivered a little set-back, because today, it actually hurts.

The other good news is that I *can* hike, but I do need to be careful in that, and in everyday activities, to avoid re-damaging or annoying the whole shoulder.  I think that I’m going to have to just assume that I won’t be able to climb for a year, and concentrate on rehabilitating the shoulder during that whole time.

I was upset that we couldn’t do our annual wedding anniversary climb in April, but I know that there are far worse things that could have happened, so I’m going to TRY to be patient. . .

Because I can still hike, we should be able to finish up our little project of getting to the highest (natural) point in each of the 50 states when we go to Hawaii in September and October.  (Of course, given that there is a road to the highest point in Hawaii, Muana Kea, we should be able to succeed no matter what, but our preference is to hike up it.)

I’ve also discovered that apparently about 50% of my friends have dislocated or damaged their shoulder, or know someone who has.   I’ve appreciated hearing all of the stories.

May you have good health AND be injury-free!