Ultimate Dislocation!

Let me preface this photomusing by stating that I am typing this article with one hand, my left hand. My right arm is in a splint and sling, as it recovers from a particularly nasty dislocation that happened about 14 hours ago. From 100+ words a minute to 20 words a minute, it tasks your patience! How did it all happen? Read on…

Today, I went to play Ultimate Frisbee with some former co-workers, ex-Stanford students, and other people this morning at the Las Palmas park in Sunnyvale. It had been awhile since I had played Ultimate, due to the recent NFL season and the fact that I had been spending a lot of time with my friends during the weekend. But with the NFL season successfully concluded, my Sundays are now free to spend my mornings playing Ultimate. I was introduced to this fast paced game while a senior in Stanford, living in the French House. It took a while to perfect my throws, but after practice makes better, and I am now a much more complete player than I was when I first played the game five years ago.

Before leaving the house I decided before leaving the house at 10:00 am my complete camera setup, the D30, an arsenal of lenses, the 17-35, the 28-70, and the 70-200, and my Gitzo tripod. I was set to take some exciting Ultimate photos for my web site to share with the everyone. The weather today in the Bay Area was great, and I was in good form with regards to my frisbee skills and speed. It had been quite some time since I exercised, including dancing, so I was a little concerned that my skills would have deteriorated. Fortunately, when the game started, I was happy to see that there wasn’t that much dropoff. I guess what exercise I had been doing, like hiking and what not, had kept my body in decent shape.

XFL Action

During a substitution during the game, I picked up my D30 with the 70-200, dialed the ISO up to 200, and began to take some in your face shots of the Ultimate action, on the playing field! The XFL had just started playing the day before and they had cameramen on the field, along with the skycam. We were joking a lot on the field, since my in your face photography was so much like in the XFL! I guess we were starting to play our brand of Ultimate, call it the XUL!

Dislocating My Right Elbow: The Sequence

It was fortunate that I had brought my camera and that people were using it when I was on the field to take pictures. It was especially good since they were able to catch my injury as it happened! I later learned that at the time of the accident, Derek, my former co-worker at DoDots, was at the helm of my D30, which was attached to my Gitzo tripod with the 70-200mm EF L lens. Since the D30’s sensor is smaller than a standard 35 mm film frame, the focal length experiences a multiplication factor of 1.6, making the effective length of the lens 112-320 mm. Derek was shooting the scene at 144 mm (effective 230 mm on the D30).

I kind of remember the disc floating in the air, almost ready to fall onto the ground. I dove for the disc, as did a number of other people. West was coming straight ahead and we collided, with him falling down on my right arm. I heard a noticeable “POP!” sound as we hit the ground and I immediately knew that something wasn’t right with me. I looked at my right arm and noticed that it was not in a “normal” position. I knew then that I had either dislocated it, or worse, broke my arm. I had never ever broken a bone in my body, leading me to half-heartedly believe that I was “unbreakable” like Bruce Willis’ character in the movie with the same name. I certainly wasn’t Mr. Glass! But, here I was, crumpled on the ground, in obvious discomfort from what had just happened.

As my senses came back to me on the ground, I remember exclaiming something to the effect of, “Injury! Broken arm!” A crowd began to form around my crumbled body, curious to see what had happened. My glasses had been knocked off during the collision with West; fortunately, the glasses were not broken, neither the frame nor the lenses. I guess I have the high index plastic and the titanium frames to thank for that! As I was laying on the ground, a group started to form around me, and one person helped to put my glasses back on. After all, it’s tough to do that with only arm! Another person used a cellphone to call the paramedics. I wonder if they just called 911 or if they called another number to get medical assistance.

The funny thing was that I wasn’t angry or mad; I thought that it was pretty funny. Well, maybe funny wasn’t the right term, but I did find it intriguing and curious. What a strange new sensation! A whole new set of feelings that up until now, 25 years after I was born, I could now experience. Like with many things, I decided, however painful it was, to relish the situation with a positive attitude.

One thought that did come to my mind while on the ground was my upcoming business trip to Boston, the next day. Well, this puts a damper on that trip, I told myself! In fact, the reason why I probably won’t be able to complete this photomusing in time is because I have to catch a plane!

Curious Feelings

I’ve read or heard that excruciating pain often accompanies a dislocation of the shoulder or elbow. Although it was painful, I didn’t find the pain to be excruciating. Rather, it was a curious mix of throbbing pain isolated in the elbow joint area of my right arm. It was as if I could feel my heart beating through the elbow. I could still feel my fingers, although they definitely were a bit numb. In addition, there was no noticeable pain felt along the upwards part of my arm or shoulder.

What I did notice, however, was a hard bony proturberance was sticking out of my arm. As I lay on the ground, I used my left hand to push the bone, which I think ended up being my radius, back into my arm. I felt it move inward, until it hit something solid. The joint was not reduced, but I am sure that I reduced the painful sight that my friends were looking at.

While lying on the ground, I remember that I had brought my camera to the event. This, in my mind, made excellent material for a new photogallery or musing! I asked anyone who was around to, “Hey, can you take pictures of this? Hurry, go get my camera!” People may have thought I was twisted, wanting to capture my pain and injury on film. They’re partially right, I am a little twisted in that sense, but I also like to take advantage of opportunities as they present themselves. Derek and Evan traded turns taking pictures of me as I lay on the ground, experiencing those curious feelings in my right arm.

Looking back, I notice that I’m wearing practically next to nothing in these pictures. Earlier in the game, I was playing on the “dark” team while wearing my Reggie White Green Bay Packers jersey. I read later on the Internet that he played in games with a dislocated elbow! Reggie was definitely the man on the gridiron, as I’m not sure if I could have continued to play Ultimate with my dislocation! When I switched teams, I had to take off the jersey, leaving me only with my cycling shorts on. To be honest, I really didn’t think too much of it while lying on the ground, with the throbbing sensations in my arm, but it’s funny to look back on the pictures with me practically naked!

Paramedics

We heard the sirens and knew that the paramedics were arriving. Turns out, the first to arrive on the scene was the fire department, led by Jim and Jerry. They walked calmly and confidently towards me, with Derek the photography in tow, taking pictures. They quickly assessed the situatin, asking me a number of questions to ascertain the extent of the injury. I was a little more excited than usual, and they had to calm me down a few times because of my chatty nature. Fortunately, nowhere in the conversation did they ever talk about getting the tranquilizers out to shut me up!

They found out that circulation was still occuring throughout my arm, which meant I hadn’t ruptured any arteries. They believe that I either had, as I knew, a dislocated elbow or a fracture. They kept me occupied until the paramedics from the ambulance arrived, Jonathan Watkins, Tim, and Vinnie. I greeted each of the people helping me with a big, “Whassup!” and asked for their names. They were great, laughing and smiling with me while at the same time being very prompt and professional in their treatment of the injury. I couldn’t have asked for a better group of people helping me out. I spent most of my time speaking with Jonathan, who instructed the group to set up an air splint for me as they transferred me to the hospital, El Camino Hospital. Somewhere during this time, someone collected my wallet from my Domke camera bag and retrieved my health insurance card. It’s a great feeling when you’re injured to know that you’ve got insurance to cover most, if not all, of the costs associated with getting back to be healthy.

When they brought the stretcher and the air splint out, I felt like I was in the NFL, XFL, or at least the XUL! I can only imagine what the “television audience” was thinking at the time, as I lay on the ground with the medical staff working on me.

They loaded me up onto the stretcher and took me to the ambulance. Joy and Karen helped me by giving me my cell phone and wallet, which I used to call a few people on my way to the hospital. No one but the paramedic staff accompanied me on the ambulance. I drove, obviously, in the back of the truck with Jonathan; we entertained each other about various medial facts and stories. I’d never driven in an ambulance before and this was also an experience for me to relish and enjoy. I wish that I had brought the camera along with me for the ride as I would have gotten some cool pictures there! That being said, I hope never to be in an ambulance again as a patient!

Inquiries at the Hospital

They sure ask some interesting questions at the hospital as they are checking you in. “What is your religion?” was the first question that threw me off. I mean, what does it matter what religion I am?!? After joking with Jonathan and the nurse about this, I replied, “Uh, I’m more spiritual than I am religious, so let’s put ‘other’ down as my religion.” I was talking with my friends and family later in the day, and they said that they probably ask that question in case you die or something. It would let them know to what to do with your body, like orient it towards North or something like that! The kicker, however, came when the nurse asked the next question, “Okay, now… do you consider yourself white or Asian?” “What?!?” I exclaimed at the incredulity of the question, while answering, “Of course, Asian, no… wait, Black!” I later learned from my friend, Eric, that on birth certificates in the state of Texas, there are only two options, white or black. Someone we both knew from Stanford is legally white in Texas, even though he’s Indian!

I’d buy that for a dollar!

The night before, just prior to going over to the Hawaiian Party held at Stephanie, Sangeetha, and Adriana’s apartment in Menlo Park, Randy and I were watching the end of Robocop on Channel 36. Robocop’s partner, Lewis was explaining to him that she was a mess, to which Robocop said, “They’ll fix you up, they fix everything…” How appropriate was it when the public relations lady, Irene, at the hospital kept saying to me, “Don’t worry, we’ll fix you up!”

The hospital staff arranged to have x-rays taken of my arm, which was still contained in the splint. They put an orange tag around my left hand with the name of the doctor who I thought would be treating me, Dr. Klapman. The orange band looks like those bands they hand out at clubs and bars around town. I joked with the staff member who put it on if I could now get a drink from the bar! The x-ray technicians came in an took two x-rays of my arm. Because of the dislocation, I was unable to bend my arm in a 90 degree angle. We would have to reduce the dislocation in order to get those x-rays. The moment of truth was arriving, and Dr. James LaRoy, not Dr. Klapman, was the messenger.

On a scale of 1-10, how painful is it going to be?

That moment arrived when Dr. LaRoy stepped in the room after the x-rays were developed to set the bones back in place. He asked me, as Audrey had before him, if I wanted an IV with which they would pump me full of morphine. I replied to him with something to the effect of, “I want to feel how painful it is; I don’t want any painkillers.” Call me a tough hombre or a sado-masochistic fool, but I really did want to experience the sensation of my elbow being popped back into place. Since this was the first time I’d ever seriously did something bad to my body, I was intrigued by the new sensations flowing through my body, or more to the point, the throbbing sensation in my right arm.

I told the doctor that on a scale of 1-10 of pain, with 10 being the most painful, that my elbow was around a 4-6. I then asked him what this was going to feel like, setting my bones back in place. Without hesitation, Dr. LaRoy replied, “Ten.” Oh, maybe I should take up his offer for the morphine, I joked. There was no turning back though, and I wanted them to proceed. The doctor and Mike had to tag team to set my bones back in place, with Mike holding my swollen bicep and upper arm steady while Dr. LaRoy pulled my ulna bone down and back in the socket. They struggled for a few minutes, and I must admit that the pain did rise to a 7 in my book. The good doctor said that this was a tough one, but I tried to urge him and Mike on, “Come on, you can do it! Harder! That’s it!” In another environment, those words might be misinterpreted, but I have to say that the feelings were quite intense.

Dr. LaRoy was impressed with my pain tolerance, noting that in 35 years of practicing, no one has ever asked him to put an elbow back in place without pain killers! He was wondering what I had been drinking or taking (nothing, just a positive attitude), relating the movie scene from When Harry Met Sally and the fake orgasm scene by Meg Ryan. “I’ll have what he’s having, please!”

Eventually, they believe they managed to set the elbow back in place. It was difficult to tell since there was a lot of swelling in my elbow area. They needed to take another dose of x-rays to be sure.

I received the following quote from Dr. LaRoy a few days after my trip to the hospital:

“Adam- you had just about the best attitude a Physician could hope for in a patient! Your ability to relax in that situation was amazing! I don’t expect to ever have someone say “cool” with a smile on their face when I tell them something is going to cause them severe pain!”

The pictures that you see at the hospital were taken by my friend, Derek, who came to El Camino to make sure that everything was okay and deliver me my camera equipment and personal stuff that I had left on the Ultimate playing field. It’s good that we came, otherwise, we wouldn’t have been able to reenact the reduction procedure with Dr. LaRoy and Mike, nor see the happy, “Hey, a new toy!” expression on my face when I had the splint wrapped around my arm.

After they reduced the dislocation, they took a number of x-rays before placing a fiberglass splint on my arm at a 90 degree angle. They wrapped up the arm, told me to rest, elevate and ice the arm periodically (which I forgot to do for almost two days, unfortunately!). Then, with my new toy firmly wrapped up, they discharged me from the hospital into what seemed now a slightly different world.

The euphoria and newness of having a dislocated elbow soon dissapated over the course of the next few days as I began to integrate my useless right arm back into my life. One thing about breaking or dislocating your dominant arm; it makes eating and doing normal tasks soooo much harder! You really gain an appreciation for what you have. I went to dinner with my friend, Eric, and it was a challenge to eat with my left hand, even with fork! And, don’t even think about chopsticks; I was horrible!

The next few days following the accident, my arm swelled up to enormous proportions; since the splint pushed up against my arm, the swelling travelled by way of the path of least resistance. In medical terms, this is called window edema, and it’s not a pretty sight, as you can see in the picture to the right. Window edema certainly makes the injury look worse than it actually was, though that isn’t to say that dislocations are trivial injuries. I realized quickly how fragile of a state my arm was in. When out of the splint, I had to support the arm at all times, as it truly was useless. Taking showers (I ended up taking baths), eating, tying my shoes, and buttoning shirts, all of these simple tasks became extremely difficult with the use of one arm.

Update: February 23, 2001

The day after my ultimate injury, I left San Jose early in the morning for a business trip to Boston. The night of my injury, I didn’t sleep a wink, preferring instead to work on this web page and adjust to the new feelings in my arm. The following week, I flew out to Phoenix, Arizona for the Demo 2001, followed by another trip to Boston. The next week, I made my third trip to Boston, where I met up with friends from Stanford, such as Clara, Irene, and Tamar. Before the trip to Phoenix, I didn’t need to wear my splint anymore, although I did still need to support it with my sling. The week of my third trip to Boston, which marked the start of the third week of healing, I didn’t wear the sling anymore. Today, I’m able to do many more things that were all but impossible two weeks ago, such as typing, washing my hair, or carrying light objects.

Still, I can’t do everything, like extend my arm fully or bend it back completely. I’m hoping that these abilities will return to me in the near future, as the main goal is to return to pre-injury abilities with my right arm. I won’t accept anything less. As I write this update, I am on a plane taking me home from my third trip to Boston. I see Dr. Test, my orthopedic doctor picture on the right, to go over next steps in my rehabilitation process. As the dislocation deals, one has to relearn how to use the arm again; it’s a fascinating process and a testament to the remarkable healing powers of the human body. I don’t want to have to go through something like this again, but I’m thankful that I have experienced it, for now I understand the pain, suffering and difficulty that others struggle through with similar injuries.

Update: February 3, 2002

One year later, I look back at my dislocated elbow experience.

Resources and Links

Here are some links to articles related to dislocated elbows on the Web:

• American Academy of Orthopaedic Surgeons’ Fact Sheet on Dislocated Elbows
• St. John’s Health Center page on dislocated elbows
• Dislocation of the Elbow at DynoMed.com
• Acute Elbow Dislocation Clinical Techniques
• Elbow dislocation at HealthGate.com

There are some more pictures from my ultimate dislocation in the photo gallery below!

Update: November 25, 2002: Watched Monday Night Football tonight and saw Eagle’s QB Koy Detmer dislocate his left elbow (non-throwing) on national television. Ouch! He must have landed more awkwardly than I did, because he seemed to be in a tremendous amount of pain. Best wishes to Koy on his rehabilitation! Although I am a 49er fan, I don’t like seeing the opponent get hurt.

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