Sunday, August 28, 2005

The Cold Shoulder

Having started this level of exercise so late in life, it's clear that some parts of my body respond better than others. The more I follow the karate regimen the more I wish I had started sooner. There's so much to catch up on.

I really fell out of shape when I had shoulder surgery in 1995. From the time I was 15 or so, my left shoulder would fall out of its socket. I remember when it happened the first time quite vividly. I was away at a sports camp, minding my own business trying to sleep after a hard but fruitless day on the baseball field. Suddenly, we heard a common chant "Cabin 1, this is cabin 2; we're coming to take you on!" (Come to think of it, no one in camp was capable of shouting with a semicolon, so I should have used an exclamation point there, but I digress...) We were cabin 2, so we knew someone was trying to hoax us into trouble. The various cabins had some competitions at camp, but nothing to make this vicious. This was just a well-executed prank.

It was executed well enough that Vanderbilt, a red-haired, chunky, 16-year old counselor with thick horn-rimmed glasses, strutted in to our cabin of old wooden bunks and ordered all 30 or so of us onto the floor and into push-up position, the common group punishment at the camp. I've long forgotten what cabin Vanderbilt was assigned to, but he went to school with Ryan and Day, our cabin's assigned counselors, as did most everyone else. It seemed everyone was recruited from the same Bronx high school. Vanderbilt was probably ticked because this prank interrupted the counselors' campfire and soiree that they had every night by the basketball court. Everyone knew not to get him riled. Teenagers always poke the sleeping giant, so if they could get him riled and have him direct his anger to someone else, it provided unmatched entertainment.

After a couple of minutes,I remember my left arm collapsing under me, and also being very confused. I had no idea that it was falling out of its socket, it seemed like a huge muscle twitch, and by relieving the pressure on the shoulder, it stopped. I never thought of it again until about seven years later at college, when I was walking down a short flight of stairs, twisted my body in some way to switch my books to my other arm, and it happened again. About five years later, it fell out of socket again when I was bending over to pick up a Sunday newspaper at a store; I nearly fell over trying to get it back in socket, but it went back quickly. Sometime around 1992 it started happening often, usually when I was turning over in my sleep. It would wake me up immediately. I would jump up out of bed, scaring my wife, grabbing my shoulder and gently nudging things back into position. The night that it took five minutes to get it back into place was when I decided to do get serious about doing something about it.

A visit to the orthopedist let to some physical therapy sessions and exercises to strengthen the muscles to hold it together. After about six months it was clear that it wouldn't work, so we scheduled surgery.

The most memorable part of that February 1995 day was reading the legal forms down in admissions. The phrase "patient recognizes that medical procedures are an art, not a science" or some weasly waffly sentence like that just struck me as hilarious. For about five weeks I was in a huge cast and spent the time wearing sweatpants and XXXL Wal-Mart flannel shirts cut to allow for the cast and the sticks coming out of the plaster around my waist and supporting my arm, which was at a 45 degree angle to my body. It became an adventure to get through doorways. The only time I left the house was to go to the doctor. I got into our Accord wagon by going backside first into the back seat and hoping for the best. Somehow, I managed to keep up with hygiene during that time, but I knew that the first shower once the cast was off would be unimagineably good, and it was. Our house still has some gouges in mouldings that indicate what an adventure turning and walking through doorways would be. I did manage to keep working, typing with one hand. Since I had never been taught how to type correctly (nor did I ever have the initiative to learn), it just meant that hunting and pecking took a little longer.

The day they took the cast off at the end of March was quite an event. My back muscles and arm muscles had atrophied, so a got a shot of pain that was so unbelievable that my eyes started to roll back in my head. Somehow they kept me from fainting. They got me back on a gurney and took x-rays again. I was convinced my arm was falling out again, but they assured me that it wasn't. Vicodin became my best friend that week.

To keep my arm in, they set it higher in the shoulder socket and a little forward, after they put the cartilage sack back in place, and tightened the tendons to the point where I could not lift my arm off my chest. (It's not noticeable unless you're looking for it, at which point it becomes obvious that something's not right). From there on in it would be physical therapy for about six months. Somehow all those years of neglect necessitated an open shoulder repair, and not the more simple arthroscopic surgery that would have been much easier to recover from. Recovery was slow. I tried swimming, which helped (though it looked kind of funny), but those sedentary weeks really put some pounds on, too, and they were tough to get off. The physical therapy was quite painful, but eventually we saw progress after a few of weeks wondering if anything was going to happen.

To this day, I have trouble lifting my left forearm to my head, so I'm always wiping karate sweat on my right sleeve. Any kind of left arm side block is never in line with my body, giving me what looks like bad form, but it's one of those "best as you can do" kind of things and I just have to compensate some other way to protect my exposed area since my elbow can't get in position the right way to protect my ribs, nor can my hand protect my face correctly.

I've always believe that I incurred some nerve damage from the operation, which still haunts me to this day. After the surgery, while I was in the cast and out, it was always dangerous to hold a glass in my left hand. I dropped a few of them, and what was always funny about it was that my hand would remain in the position it was when the glass was originally there. My fingers and thumb would still be curled in the exact position around a phantom glass, but there would be spilled liquid and glass pieces on the floor around me.

Today it manifests itself as a numb arm that is tough to describe. I have plenty of feeling in my arm when I start working out or start a class, but after some hard punches or hard blocks, the arm goes numb. I know it's there, and I can command it, but pain radiates up and down it and I lose some fine motor movement in my fingers. I can make a fist, but it's not a hard fist, and if it is, I can't feel it. It's not that my fists are all that good anyway, but at least in my right hand I can tell when I'm making a good one. It's all very strange, but usually goes away a few hours after class is done, and the next morning it's fine.

After taking karate seriously for a few months, I was hurled out of bed one night with a loud noise and a shot of pain. It was the "ping" sound that I had after my surgery when scar tissue adhesions would break free in the repaired socket. These adhesions would limit my movement, but once they popped with a shot of intense pain, the arm would always feel better, and I would have greater range of motion, and a strange sense of euphoria that comes with progress. This happened quite a few times for a couple of months, and it was clear that karate practice was starting to stress the shoulder much like my physical therapy had done, and it was helping me out considerably.

There are still some things I'm not allowed to do, like extensive push-ups or anything that presses into the shoulder. I've often wondered if I had started something like karate when I was in my teens if I would have had a better-rounded athletic experience than just phys-ed class alone (where I was just one of the nerdy kids picked close to last when picking sides). Perhaps I would have been able to avoid these problems.

It's amazing how all these things come back to haunt you years later. There are times during class that these events flash in my mind, especially when I see younger students doing things so effortlessly and smoothly, untinged by adulthood's problems and aches and pains, and all the stuff that happens to us that we thought at the time is kind of meaningless. Things have a habit of compounding over time, don't they?
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