The word "dislocation" has a completely different meaning to me now ....

Richard was 20 years old when he dislocated his shoulder for the first time...

I can remember the moments before my dislocated shoulder like it was yesterday. I was playing rugby for a college team during the fall season. It was a typical blustery day, the sun was moving in and out of the clouds, and the field was a bit wet and springy after an early morning rain. We had a good side that year and we were on a bit of a roll, having won our last three games. I loved the game of rugby at that point in my life. I had never been seriously injured, and I suppose that I thought that I was never going to be. Maybe it's all in my imagination, but I remember just before I was tackled this odd feeling like something just wasn't right. Maybe it was the position of my body, or the way that I was running, because I don't really remember the exact mechanics of how it all happened, but somehow I was tackled and everything went completely quiet. I couldn't feel anything but I could hear the blood rushing in my ears and I could feel this searing pain in my right shoulder. I can honestly say that I had never felt anything quite like it before.

The word "dislocation" has a completely different meaning to me now that I have felt what it is like to have your shoulder pulled out of joint.

Before I was injured, "dislocation" had an abstract quality, but afterwards, I could associate a real feeling with it. A feeling that something was truly wrong with your body, like your arm had almost been pulled out of your chest. I lay on the ground, gasping for breath. I couldn't lay still because the shoulder pain was so terrible, but every time I moved, it just made it worse. A trainer from the other team came out and examined me. I felt his fingers push around the muscles of my shoulder, and he tried to move my arm, but I was holding onto it as tightly as I good with my good arm, clutching it to my chest. There wasn't any way that I was going to let someone move my arm, and I think he managed to figure out that I had either had a broken my arm or a dislocated shoulder. Somehow, with a lot of help, I managed to stand up. My arm felt like a dead weight. I could move my fingers and feel with my hand, but I felt like the entire limb just wasn't a part of me anymore. I sat down on the sidelines. Every time I took a breath it nearly brought tears to my eyes. I knew that I needed help, someone had to put my shoulder back into the joint, but first I had to get to the parking lot and have someone drive me to the hospital. There were plenty of offers, and maybe it was just the confusion created by the fact that the game had started again, and that time had slowed down for me, but I felt like I sat there forever before my roommate gently helped me standup and walk to the car. I have never had to count steps like that before. The numbers kept repeating themselves over and over it in my head, 1…2…3…4, up to ten, and then I would start over again. Somehow I managed to get to the car and fall into the passenger seat. I couldn't close the door because my right arm just wouldn't work, and I didn't seem to be able to reach across my body to pull it shut. My roommate shut the door, and I'm sure that he didn't mean to, but it banged into me as it closed, and I swear that I must have said some terrible things in a fog of shoulder pain.

I got to the emergency room, and of course I didn't have my wallet with me. It seemed so obvious to me that something was wrong, that I was sure that the moment I walked in the door I was going to be whisked away and all of my pain would be relieved. Instead I sat there talking to a nurse who was trying to have me fill out a form. I'm right handed, and I could sort of scribble on the form with my right hand, but I didn't have any idea what my insurance number was, or who my carrier was for that matter. I finally said the only thing that managed to come to my mind, "Blue-Cross, Blue-Shield". I'd seen enough ads on television to know that it seemed like a perfectly good answer, like it was some sort of a guarantee that someone would do something for me. Well, maybe she just took pity on me, but at some point I was taken to room inside the emergency room and told to lay down on a stretcher. A nurse came in the room and started an IV in my left hand. Strangely enough, that was almost the worst part of the entire experience, because for the first time I had to let go of my right arm, and now it felt like it was just going to fall off. Every time I took a breath I could feel this grinding in my right shoulder and the muscles of my shoulder would go into a terrible spasm.

The IV was started and I waited. I remember looking at the clock and it was at least forty-five minutes. Finally, after what truly did seem like an eternity, a nurse came in a gave me shot of morphine in the IV. For the first time in my life, I fully related to the Rolling Stones saying, "sister morphine, turn my nightmares into dreams". I was able to take a deep breath and I gradually felt the shoulder pain ebbing away. They took me to the x-ray room and took a couple of pictures of my shoulder. For one particular view they had to move my elbow away from my body. I was terrified that it was going to send me into uncontrolled spasms, but the technician was very gentle and it wasn't terribly uncomfortable. When they finished, they pushed me back to the ER and I waited for Dr. Wilkerson.

After a while he came in. I could tell he was in a rush, but I wasn't exactly looking for a psychiatrist either. I wanted him to fix my dislocated shoulder and just send me on my way. After asking me to do a couple of things with my finger and thumb, he slipped a bed sheet around my chest and pulled it up into my right armpit. The nurse flattened the bed out and gave me another shot of morphine and something that they called "Versed", which they said was a muscle relaxant. I closed my eyes and tried to pretend that I was lying on a beach, because I was feeling very warm, flushed, and sleepy with the medications that they had given me. When they started pulling on my arm, it was like having someone trying to wake you up when you are so tired that you can barely open your eyes. I knew that they were moving my shoulder, and it did have a dull throb that was getting worse the harder he pulled on it, but eventually I felt, and I swore that I also heard, a "clunk" as my shoulder slipped back into joint. The pain didn't go away, but I sure felt better afterwards.

Eventually I felt, and I swore that I also heard, a "clunk" as my shoulder slipped back into joint.

They let the medications wear off, gave me a sling, had me sign a bunch of papers, and I left the ER with my roommate. He said that I had been there for four hours, but after it was all over, it seemed like a lot less. I had a prescription for pain medications, and they gave me four to go home with. I took two the first night, and the next morning I felt so groggy and fully of cobwebs that I didn't take the last two, and I never filled the prescription. Maybe it all went in one ear and out the other, but I certainly don't remember being told that my shoulder was likely to dislocate again. I went to see the Dr. Wilkerson at his office after about a week and he gave me a bit more information. He said that I had to strengthen the muscles around the shoulder in order to prevent it from slipping out again, and also avoid certain activities that would put my shoulder at risk.

I started by doing something called pendulum exercises, where I took arm out of the sling, bent forward, and gradually made little circles with my hand. After about a week or two of that, the trainer gave me some rubber tubing that I tied to the doorknob in my dorm room, and I started doing the exercises that he showed me. My shoulder was sure sore, but it felt more like a deep bruise in the muscle than anything else. I could feel that my shoulder still moved easily, but if I got it too far away from my body, I would feel really nervous that it would dislocate again. I continued following the trainer's advice. After about six weeks, I started using weights again. When I looked in the mirror while lifting weights, I could tell that a lot of the muscles around my shoulder had shrunk and the entire arm seemed much smaller. Spring came and went. I didn't play and rugby for the rest of the spring semester, and while I was pretty diligent about doing the exercises and getting into the gym four or five days a week, by the time that finals came around I had let the program slip. My shoulder felt fine. It was strong, and I was back to doing nearly everything that I wanted to do again.