Thank you science and Doctor Blaine

September 4th, 2013
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I have to be careful here or I might actually get teary-eyed, which almost never happens….

Recently I broke my right humerus just bellow the shoulder.  I broke it badly,  I broke it very very badly.   This was not just a clean fracture.  I am talking about a nasty, complicated, jagged, destructive break.  If that is not bad enough, the joint was badly dislocated.  The ball on the end of the fragment of bone no longer engaged the shoulder rotator cuff and was pushed to the side, sitting in my upper arm.

It was not clear that my shoulder joint could be saved.  The orthopedic physician who saw my injuries told me it was the kind of job that necessitated a the best surgeon available.  Still, there were no guarantees, even with the best, that my joint could be saved.

If it could not (and that looked like it might well be the case) then I would have to have it removed and replaced with a fully artificial shoulder.  My bone and cartilage joint would be replaced with one made from metal and ceramic.

Of course, joint replacements should themselves be considered an important feet of science.  Millions have recovered from severe injury or had their lives drastically improved thanks to the technology of orthopedic joint implants. If I had to receive a shoulder replacement, I would have been benefiting from modern medicine, enormously.

Still, for an active 31 year old, living life with an artificial shoulder is, at best, sub-optimal.  There are complications that can occur.  The durability and range of motion can’t match a natural joint, and I would likely need the prosthetic replaced, perhaps multiple times.

Thankfully, that’s not what happened. If I had experienced this accident ten years ago, or if I had been admitted to a different hospital, that probably would have been the case. However, I had the great privilege of ending up at Yale New Haven Hospital. In addition to the hospital providing extremely attentive and high quality care, I was able to have Doctor Ted Blaine preform the surgery.

Doctor Blaine is one of the best shoulder and elbow orthopedic surgeons in practice. He is the head of the department at the Yale school of medicine. He is also very active in research and development of better surgical methods and teaching new doctors how to preform the procedures.

It took more than four hours of surgery and what Doctor Blaine described as “A lot of screws,” but my joint was put back together and my original anatomy retained. At present, I have little use of my right arm, and I probably will need to have it immobilized for upwards of another month. After that, I face a long process of physical therapy. However, I am expected to recover normal function and use of my right arm, though it may be several months before I reach 100%

Here is a video of the man who saved my shoulder:

Of course, I have communicated to Dr. Blaine that I would be eager to participate in any medical research. In fact, I would fully consent to invasive procedures or to experimental rehabilitative techniques that carry the risk of setting back my recovery or being inferior to standard methods.

My desire to participate in such research comes, in part, from my enormous gratitude and respect for the scientific knowledge and hard-working researchers who have helped make my recovery possible. However, it is also because, even despite the excellent care I received, this has been, quite literally, the worst experience of my life. After the anesthesia wore off, I experienced two days of physical pain I could not have even comprehended before. I have had my share of minor injuries, but nothing can come close to the agony of the post surgical inflammation. This was not due to any inadequacies in my care. I was given the most powerful painkillers possible, including high doses of IV morphine. But it did very little. The pain is simply due to the nature of the operation required. Thankfully, it was temporary and the hospital did do everything possible to provide some relief.

When I think of the pain I experienced as well as the long and difficult recovery I face, I can’t help but be heartbroken by the thought that millions of people will experience such agony and worse. For many, it won’t be temporary. Most will not get the quality of care that I did. After this experience, I hope that there is a way I can help advance scientific knowledge and reduce human suffering, perhaps leading to more people not needing to go through as much as I did.

Finally, and on a slightly unrelated note:

Bikes are great. They are a simple and elegant form of human-powered transportation. They provide for enjoyable and low-impact method of exercise. They allow people to travel locally while experiencing their community in a more direct way than being inside a car. They are a great way to avoid traffic, enjoy the fresh air and save some money on gasoline.

While I am all for biking, and will surely continue to bike ride, it is certainly not a risk-free activity. On a bike, there’s really nothing separating the rider from being thrown off and injured.

Please wear a helmet and exercise due caution. When in doubt, be more conservative with speed and safety boundaries.

I know this is obvious, but, given the circumstances, it’s worth repeating.

This entry was posted on Wednesday, September 4th, 2013 at 6:46 pm and is filed under Good Science, personal. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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16 Responses to “Thank you science and Doctor Blaine”

  1. 1
    DV82XL Says:

    I too started to ride a bike this Summer after decades of not and I must admit that I haven’t been that careful especially about using my helmet but your accident and the running description of the impact it has had on you that you have shared with us on here and on Facebook has made me mend my ways. You are literally half my age and clearly had I suffered the same event it would have ended my life or left me so diminished it might as well have.

    Part of the problem, I think, is that for most of us our days of biking ended in our teens, concurrent with acquiring our drivers licence. Just as ability to ride a bike is something one never forgets I guess HOW we rode back then is also coded into our nervous system and that doesn’t take into account the other changes our bodies have gone through in the interval and we are very different in that regard than when we were 16.

    I will still ride, but I will keep in mind that kinetic energy is equal to the mass multiplied by the square of the speed, and unlike when I was a teen, I am not immortal.

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  2. 2
    drbuzz0 Says:

    I should have been wearing a helmet and I was not. I took the bike down from my apartment and forgot the helmet. I should have gone back up to get it, but I figured it was no big deal. It would not be a long ride and I never needed one before and had ridden without a helmet plenty of times.

    I was lucky I was not killed or hurt much worse, because I could have been. In movies people get knocked out and they come to later like it is nothing. That is not how it really is. if you are hit in the head hard enough to be totally unconciouse for more than a few seconds, it is a very serious medical emergency. Only severe trauma makes the brain shut down like that.

    When I got to the hospital it was clear my arm was broken, but the biggest concern was the trauma to my head. a broken arm would not kill me, but a hard hit on the head just might.

    I fractured my skull. it was minor. it was basically a crack running along the skull. there is no treatment, just be careful until it heals. no fragment of bone broke off and went into my brain… but it could have. also no blood vessels ruptured and caused a pool of blood in my brain… but it could have happened. that was the initial concern.

    I think I am now almost completely over the concussion. but it did have me very fattigued.

    When I hit the ground, apparently my arm was the first thing to hit. i must have had it in front of me and it broke as it absorbed the brunt of the energy. If I had landed directly on my head, I believe there is a good chance I would be dead. Even if i survived, there is no way i could have avoided a life altering brain injury.

    In that regard I am very lucky.

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  3. 3
    TomT Says:

    I’m so glad to hear you got a good surgeon who fixed your shoulder. An artificial joint does age and fail over time. And it never acts as well as the original joint did. If you instead get a good surgeon who can fix it, that is fantastic.

    And yes bikes are dangerous and need to be treated with respect.

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  4. 4
    Matte Says:

    Nice post…but more to the point it is good to hear that you are on the mend!

    Keep on slugging, physio is a pain in the posterior!

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  5. 5
    ThisGuy Says:

    Having broken my ankle in 3 places 2 years back and only being able to walk normally because of a good surgeon, a steel plate, 8 titanium bone screws and a piece of wire I can whole heartedly agree on the Hurray for modern medicine and modern joint rebuilding techniques. (And directly after my hospitalisation and surgery also Hurray for morfine.) I can only begin to imagine the agony caused by a splintered collar bone.

    I will add to the call for bike safety with another warning: If there is a chance of ice forming on any road surface, leave the bike at home. 2 wheels are just not safe if one of them can lose grip in a split second.

    I wish you speedy recovery drbuzz0. Physio is a pain, but it’s also much needed to get strength back to disused limbs.

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  6. 6
    drbuzz0 Says:

    I will add that a very surprising revelation from this incident is that the opiate pain medication proved much less effective than I had expected.

    Ocixodone(sp?) worked okay, but not great. However, morphine did not seem to work at all. right after surgery, when the pain was worst, I was given a large dose of IV morphine. Mosphine is the gold standard or management of bad pain, so I fully expected it would give a lot of relief. It didn’t.

    It certainly had an effect. It gave me a full body rush and made me feel disconnected and intoxicated. Under different circumstances, I am sure it would have been very pleasurable. But at best it just distracted me a little. It did not reduce the pain at all.

    There is a subset of the population, about 10%, who do not respoond to the pain killing effects of morphine. I now believe I am very likely to be in that group.

    this is something I want to talk to my doctor about, If I am, I might be a good test subject for studies on pain management because of this unique, but relatively common trait.

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  7. 7
    Matte Says:

    Actually, morphine is pretty bad as a painkiller. It is more of a pain management drug.

    Yea, it still hurts like hell…but you don’t mind it so much!?

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  8. 8
    Sean McKinnon Says:

    Yeah, I found that opiates did not really do much for actual severe pain they just make you not focus on it as much. I think the Percocet (oxycodone with APAP) and Vicodin (hydrcodone with acetomenaphin) analgesia is actually the inflammation relieving properties of the aspirin and Tylenol.

    Supposedly our bodies convert all the opioid drugs into morphine.

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  9. 9
    DV82XL Says:

    Of course if you are still suffering pain, you could always try this:

    The Amega AMwand

    which was recently feature here:

    The Hibiscus Moon Crystal Academy

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  10. 10
    Dionigi Says:

    Nice to have you back and good luck with your continued recovery

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  11. 11
    PsihoKekec Says:

    The description of the injury was painful to read, I can’t even imagine how it was for you. We are fortunate that we live in this age of medical advancement when injuries that decades ago would certainly kill or cripple you are now survivable or even fully recoverable. It’s best not to need medical attention, but short of living in a sterile padded room I don’t know how that would be possible. I hope that you will make a full recovery after this.

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  12. 12
    Christopher Says:

    Welcome back.

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  13. 13
    drbuzz0 Says:

    Unfortunately it will be at least another two weeks before I am posting much else. I still have limited use of my right arm and I am extremely occupied with follow ups, piled up obligations and such. I am soon to start physical therapy which will also take up a lot of time.

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  14. 14
    Engineering Edgar Says:

    Sorry about your accident. Glad you are recovering. Be careful!

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  15. 15
    Flyboy77 Says:

    I broke my arm about fifteen years ago and they also had to do surgery. I’m not sure if it was as bad as yours, it sounds like it wasn’t. Still, bloody painful and had me laid up for about two months, not really able to do a lot for myself.

    I hope you are better soon, but do not rush it and don’t feel pressured to do something silly like update your blog when you have a lot of other stuff to do and need to get better. Stuff can really pile up fast. Your health and recovery needs to be number 1

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  16. 16
    Cristina Miller Says:

    I came across your website as I was surfing the ‘net about Dr. Ted Blaine, my son’s shoulder surgeon. I was feeling very blessed and grateful for the progress Steve has made since his surgery almost 2 months ago, and was looking for Dr. Blaine’s email to send him a note to thank him.

    A little background….my son, Steve, played football in high school… in his Sr. year he was running in for a touchdown, was tackled by 3 d-men, and fell hard on his shoulder which dislocated immediately. The team physician was able to put it back in right then, and after a week of soreness, Steve was fine. A few months later while skiing, Steve went off a jump, went too high in the air, and fell hard on his shoulder which dislocated once again..this time it was a trip to the mountain’s emergency room and it took an hour to get his shoulder back in. Too make a long story short…Steve went on to dislocate 5 more times (all the while going to PT). I know you’re probably thinking…why did you wait so long to have the surgery? Well, he also had hand surgery during this time (Dr. Dodds performed the hand surgery, another amazing surgeon in the group)…so he needed to heal from that before he had the shoulder surgery and also attend his high school graduation.

    During this time, we learned that when you dislocate your shoulder while under the age of 24, your chances of re-dislocation are huge and the percentage goes up every time you dislocate. And every time Steve’s shoulder dislocated, we had to take him to the emergency room. The shoulder never went it by itself or even with our trying to manipulate it back in. So between the brutal pain and the emergency room visit, it was a nightmare every time it happened.

    He finally had a 4-5 hour arthroscopic surgery on the shoulder in August and started PT 6 weeks later, doing everything the surgeon instructed. Unbelievably, after all he’d been through….at 4 months post-surgery, on December 23rd at midnight, Steve playfully pushed a friend and out popped the shoulder again. It was the worst night of his (and our) life. There he was again in the emergency room at 1am on Christmas Eve…in agony. We were horrified….Steve cried and so did I. How could this happen??? He did everything right…he was conservative, went to PT religiously, and the push on his friend was mild….and he was 4 months post-surgery! We immediately called his surgeon and set up an appointment. She said to “wait it out” claiming that the dislocation could have been a fluke, the muscles are still weak, blah, blah…she told us basically not to overreact. Well, I wasn’t buying it. And sure enough, a week later on New Year’s Eve, Steve SNEEZED and his shoulder came out again…back to the emergency room. Now it’s TWO dislocations post-surgery (not a fluke) and we are all crushed and feeling desperate. At that point, I frantically email Steve’s shoulder surgeon (won’t name names), while cc’ing others in the same practice, basically begging for help. Soon after, Steve was assigned to a new surgeon, Dr. Blaine (after additional MRIs, 2nd opinions, etc).

    We scheduled a 2nd surgery with Dr. Blaine and on Feb. 19th, Steve had open shoulder surgery…and now has 2 titanium screws in his joint. He should have had the open surgery with the screws the first time…but we are not looking back, we are looking forward. And so far, so good. Steve knows this will be a longer recovery…but if it keeps him out of the emergency room, he doesn’t care what it takes. Dr. Blaine is very confident that Steve will even be able to play lacrosse at Ithaca College in 6 months or so. Time will tell. But for now, we are so grateful that Steve was able to have Dr. Blaine perform the 2nd surgery and we are confident that he will recover 100% eventually with NO more dislocations.

    On a side note regarding post-surgical pain… The second night after surgery, the nerve block wore off. Even with taking more than the suggested amount of opiates, Steve was in agony. We were thisclose to taking him to the emergency room to get morphine or to have him put under and out of his misery, but he begged us not to take him, at this point he is scared to death of hospitals having been so often now, and just wanted to be home where it is “safe”. The oxy and valium combo did Zip, Zero that night. His agony lasted 4 hours. We coached him through the pain somehow with breathing exercises (similar to when you are in labor) and I even tried reiki, prayer, cool washcloth on his head, etc. ..he finally fell asleep from pure exhaustion (around 4am) and woke up 8 hours later with NO pain. The whole night was like some kind of surreal nightmare. He still talks about the pain to this day and says that if we (mom and dad) hadn’t been there to see him through the night, he may have done something drastic – he was in that much pain. The pain he felt that night changed him. He is a more loving, appreciative and compassionate person. He, too, has a new sensitivity for those living in pain and would do anything to help them. I’m sure with time the memory will fade, but right now 2 months later it is still very fresh.

    He is going to PT 2x week once again and following all surgeon instructions (and has zero pain). He is making good progress with his range of motion, but taking it slow. He’s looking forward to being whole and “normal” again (not living in fear of his next shoulder dislocation). He leaves for college in August. He’s been through too much for an 18 year old or for anyone (3 surgeries and 11 shoulder dislocations in one year), but he will bounce back and be better than ever! Thank you Dr. Blaine and to every one at Yale New Haven Hospital and PT for helping my son back to health. I pray for everyone going through a health crisis that you have people in your corner that you can count on and who will get you the care and treatment that you need and deserve…

    Also as a side note…even with everything Steve has been through…he does not regret high school sports and would do it all over again. He had the time of his life. All his issues happened Sr. year…and you just can’t predict it. He still plans on skiing again, playing lacrosse, frisbee, etc. (just maybe not football) :) and has a great future ahead.
    Dr. BuzzO – how are you? I hope you are 100% and enjoying biking and life in general.

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