KaneBlog

I Broke My Shoulder/Humerus in Tijuana

August 24th, 2008

Last July 4th  weekend (about eight weeks ago) I went to Tijuana with my cousin Nate to grab a bite at one of my favorite restaurants. Sadly, no donkeys or tequila were harmed in the breaking of my shoulder. Don’t take this as a TJ-bashing story. Although there is a narco-twist, I lived in Mexico for years without anything remotely bad happening. I do hope to provide a glimpse of what’s ahead for other folks that have similar injuries. If you’ve just had a similar injury, get ready for a life changing event (at least for the next few months) and you’ll find there’s not much on the interwebs about it.

I was walking back to the border with Nate and came to one of the huge TJ roundabouts. I didn’t see any cars coming and started to cross. About a 1/3 of the way in I heard an engine rev, looked up and saw a narco looking 4×4 accelerating towards me and jerking his wheel back and forth. Seeing that this is a fight I would lose, I turned  back to the curb, promptly slipped on something and went down on my outstretched right hand. Immediately, I knew that I had blown the shoulder - those of you that have been in shock know what’s it’s like to be beyond pain. Somehow I rolled to the side of the road, didn’t get run over and made a sling out of my jacket. Doctors told me a few times after that I must have hit the arm with massive energy to cause that level of damage. So, after being offerred aspirin by at least ten friendly Mexicans and a few introductions to brothers-in-law that are good with bones I made it back to the border and on to a US emergency room. That’s where the real fun started.

Bone doctors don’t seem to hang around in emergency rooms waiting for patients, particularly at midnight on Saturdays. So, they have to call them in. If you’ve got a badly broken shoulder waiting is pure agony. In my case it took a few hours for the orthopedic intern to show up. His key decision was whether to operate right away or have me see an orthopedist on Monday. He ordered up a set of x-rays to see if the shoulder was displaced and the position of the bone. His read was that I had a comminuted three or four-part fracture in the ball of the shoulder  with a proximal fracture of the humerus. The humerus is the long bone that goes from the shoulder ball/socket down to the elbow. Comminuted means the bone is in multiple pieces and proximal means that the the ball part of the humerus is broken off from the forearm part at the neck.

So here’s what they saw when they took x-rays:

Since the shoulder wasn’t dislocated and the break was bad but not too out of place, an emergency operation wasn’t needed and he sent me home and told me to see my orthopedist on Monday. He also gave me a cheapie sling with instructions to immobilize the shoulder. By this time, the entire arm from the shoulder blade down to my elbow was swollen and painful. He also gave me some heavy-duty painkillers which I never took.

The next few days waiting to see my orthopedist I didn’t do much and discovered quickly a few aids to proximal fracture living:

-Hygiene: Showering was really painful so I didn’t take one for a week (yuck). Changing shirts is painful too so I wore the same shirt for a few days. When it was too nasty for me I just cut it off and switched to a XL button-up rather than moving the shoulder.

-Sleeping Nest: Pillows are really helpful to supporting a somewhat upright position for sleeping and supporting the broken shoulder arm. I never got less than six hours of sleep during the first month.

-Ice: I got a few wrap around the shoulder icepacks. They killed the pain enough that I got to avoid being stoned on painkillers (ignore if this is a beni!).

-Wardrobe: Nothing is more painful than getting into a pullover long-sleeve shirt. I got a new wardrobe (you may have these types of clothes but I didn’t) of loose shorts, button-up short-sleeve shirts and loose socks. I got a few XL shirts as well that I could wear on top of the sling because initially I didn’t want to move the shoulder socket at all. Changing what I wore seems simple but it was one of the largest pain/hassle reducers.

-Diet: I have NO scientific basis for this part but it seemed to work for me and I healed much more quickly than expected. I drank loads of water, stopped anything with caffeine or alcohol and went on a high-protein high-vitamin diet. All of the doctors I saw told me that anything I did diet-wise was meaningless but I really do think it helped. At the very least I lost weight rather than gained during the low-activity period.

So, I went to see orthopedic surgeons on Monday and Tuesday (2 and 3 days post) and heard the same thing from both. Essentially, I had the best type of the worst fracture possible. The proximal fracture with multiple pieces is nasty because the shoulder is a tough healer with lots of possible complications. On the positive side, the pieces were mostly in the right area. Both doctors said that they could operate and might have to replace the shoulder, but if they watched it there was a 50% chance that the shoulder would not fall apart (the pieces getting less together) and it would heal on its own. Even if it did not fall apart, there was also a smaller chance of non-union where the peices don’t heal together with a good fit. They could only do pin/plate/etc. surgery for a few weeks so I would come back every week for x-rays to see if the bones had shifted in a nasty way. My expectations were set that any way it goes it would be a 1-2 year recovery including physical therapy.

So I settled in for a wait and made a few more lifestyle changes:

-Dual-Sling Strategy: The orthopod gave me a nifty Ultrasling to replace my cheap-o-sling. As a note, make sure you take time at the office to learn how to adjust the sling. I found pretty quickly that each sling has its use. The Ultrasling is great at stabilization so I used it most of the time while sleeping or walking

around. I did need (desperately) to take a shower though and needed a waterproof, fast-drying and lightweight sling for the task. The lighter nylon cheapie sling they gave me at the emergency room was perfect for stabilizing my arm during a shower. Key skills here is switching between the slings.

This post is in progress - more to come!

Entry Filed under: Personal Musings