Shoulder fun

[joeswamp]

So a little over three weeks ago I separated my shoulder when I went down on the street (see this thread). A separated shoulder means your collarbone has detached from your shoulder blade. When this happens, your collarbone springs up (creating a big bump in the middle of your shoulder) and your arm hangs down, you have reduced range of motion in the arm and of course you can't lift as much, esp above your head.

So anyway when I first had the injury I went to this shoulder guy local to me who I was referred to by the ER. He told me that the great thing about shoulder injuries is that you don't need to act quickly, there's no advantage. You should wait until you see what you can do with your shoulder before considering surgery. Also, I had a skin abrasion over the site and you're not supposed to operate through a scab.

So last night I get a call from a shoulder guy who works at one of the top Boston hospitals -- my sister in law works there and got him to call me. He points out that if I could have acted earlier, when my collarbone was still freely moving around, he could have fixed this in like 15 minutes with a temporary screw that goes through the skin. All the original ligaments would have healed, my collarbone would have been in the correct position, etc. He's like, "Oh yeah, your local guy probably isn't familiar with this procedure but we've been doing it for years."

So now my only option is this super invasive surgery where they saw off the end of my collarbone, screw in fake ligaments made from tendons of dead people, etc. Super long recovery time, potential complications etc.

Maybe this was my only option because of the skin abrasion, but I gotta say, how messed up is this field if people 10 miles away are not sharing basic procedures? I mean, you go to a doctor assuming they have some basic idea of WTF they're doing. Even if the guy didn't know how to do it, I'm annoyed he didn't at least tell me about the option (and I'm doubly annoyed if he didn't know about it).

So here's the final lesson I learned from my crash: Always assume your physician is totally incompetent. Get a second opinion within 24 hours of the injury from the best guy you can possibly find.

[Paul_E_D]

Good lesson. The american healthcare system is probably the worst in many regards. You just found one of them. (My wife and father are both in healthcare, so I hear about it everyday). It's almost like you have to have an advocate with you at every visit just to get the right treatment in a timely way.

[SSearchVT]

Did the Dr that called you look at the x-rays and have you had any movement in the bones/ligaments since they were taken? Just asking because over the phone diagnoses can be dangerous.

Free advice over the internet - set up 2 appointments. One with the new doctor to get fresh x-rays and a complete picture, and one with physical re-hab. You might find out that you can get back to normal doing those frustrating little excercises with tiny little weights, or you might find out that you do indeed need surgery.

[joeswamp]

Did the Dr that called you look at the x-rays and have you had any movement in the bones/ligaments since they were taken? Just asking because over the phone diagnoses can be dangerous.

The only x-rays I have are right after the injury, when my shoulder was really unstable and the collarbone was really moving around. Now everything is welded together in the wrong place with scar tissue. And yes, we were just talking over the phone, anything that he suggested would have to be confirmed with new x-rays, etc.

Free advice over the internet - set up 2 appointments. One with the new doctor to get fresh x-rays and a complete picture, and one with physical re-hab. You might find out that you can get back to normal doing those frustrating little excercises with tiny little weights, or you might find out that you do indeed need surgery.

Yes at this point I've recovered a lot of functionality (maybe 70%), but the geometry of my shoulder is totally screwed up -- huge bump, different shoulder lengths, one arm hanging inches lower than the other, etc. I'm not so worried about the new requirement to get suit jackets custom tailored as much as the long term implications to, say, my rotator cuff with a geometry that's that different from standard. I'm a little worried that I might be setting myself up for all kinds of future repetitive strain injuries.

[OreoGaborio]

Friggin a, that sucks...

Glad I got a second opinion when I broke my wrist...

First doctor: "Yeah, ya miiiight need surgery... but if you want I can just cast you up now & send you on your way."
My response: "There's no "might" about surgery... give me the x-rays, I'm goin home"

Second doctor: "I'm not TOUCHIN that. You need surgery.... Here, go to this guy, he's a specialist."
Specialist: "Yup, you need surgery. Monday work for you?"


Hope ya get things taken care of & the healing process isn't too bad.

[Vulcan1500]

My brother did the same thing a few years back, but over time her returned to normal. The bump is still there, but over time it has shrunk. Second opinion can't hurt though, and your frustration over hearing your situation could be vastly different is understandable. But take it with a grain of salt - it's over the phone, and all doctors thing they're better then all other doctors.

[joeswamp]

I should also mention that my first doctor isn't just some random guy the ER found, he's a guy who only works on shoulders and has done so for over 30 years. Somebody at work told me he was very good, and then one of my wife's friend's who's a plastic surgeon said he was very highly regarded and I was lucky to have him.

So the point is that even with all this info you should assume the guy is clueless.

[jayth]

I broke my scapula 7 wks ago when i was removed from my zrx at about
40 mph. The ER doc told me before I left that I needed to see an orthopedic
surgeon and that I better find someone good because he "didn't know how
they will fix that" I took his advice and was eventually refered to Dr. Thomas
Goss at u-mass memorial he's a shoulder guru. If your looking for another
opinion I would try to see him. Good luck man I feel your pain.

[seth399]

my shoulder still gets sore from everyday stuff randomly. I had bad separation as well. My collarbone still sticks up out of my shoulder as I didn't have surgery. Mine was totally displaced but the doc still told me it was my call on if I wanted surgery or not, recovery would be about the same. I opted for no surgery so my collarbone still sticks out wierd but I am back to normal other than random days of soreness and such.

[gregp]

17 years ago I caught a cable, strung across two trees, across my neck while riding my KDX200. I separated my clavicle and collapsed my trachea. 17 years later, I still have limited use of that shoulder.
At the time of the injury, my PCP had me see a specialist. The specialist told me that "if you were Doug Flutie, I would operate on it". That remark infuriated me and I promised myself that I would never see that guy (Dr. David Doctor - no shit) again.

[Stoneman]

I've had a coupla severe separations myself. Unfortunately, I'm not one that particularly enjoys going to doctors. But I wish I had 'em taken care of when the time was right instead of waiting weeks to even visit the doctor & ortho. Now I've got a right shoulder that can't hardly through a fookin' baseball 30 feet. It bothers me to this day and the last separation occured during my m/c accident over nine years ago...

My point is if you have an opportunity to get it fixed & corrected now, I'd highly suggest you do it as soon as you can swing it...

[Vulcan1500]

Stoneman's probably right. A few months of pain vs a lifetime? Dunno. Something to think about. At least worth getting another opinion face to face with a different Doc now instead of saying "I wish" for the rest of your days.