I let out a string of about seven "Fuck"s and walked over to my relatives to tell them what had happened. I couldn't move my left arm, but I could move all my fingers, so there was no nerve damage. The pain wasn't nearly as intense as the first time it had happened, which had been the worst pain I had felt in my entire life. It was strong, but dull. Luckily, being Indian means your relatives are Indian, which means that the likelihood that one of the relatives who were around was a doctor was pretty strong. Two of them were, even. One of them pulled my shirt down to get a look and pronounced that my shoulder had, in fact, dislocated, but it was anterior this time. Before, it had slid down my arm. Now, it kind of jutted out. Nobody wanted to take the chance of causing severe damage by popping it back in incorrectly, so it was off to the emergency room with me.
My uncle drove, and my uncle-who-works-with-me-who-will-now-sim
I couldn't get out of the car myself because such a procedure involved shifting weight, and my left side was becoming rapidly useless. It felt cold and tingly. Boss-uncle helped me out as my uncle parked the car. I handed boss-uncle my health insurance card, which I had helpfully taken out of my wallet before we had left. He took care of signing me in. A waiting couple took their stuff off a chair so that I could sit down, and I thanked them.
My uncle came in and asked me if I had called my parents. I said I was KIND OF IN THE MIDDLE OF SOMETHING AND THAT SOMETHING WAS PAAAAAAAIN, and I would tell them later. What good what it do to tell them now, anyway? Of course, they were upset when I hadn't told them at all about my previous adventure; I didn't want to worry them needlessly, and they found out when they got the hospital bill.
In the waiting room, I told my story of pain over and over, including how it had happened before, a story many of you have already heard. It involved being dragged across the Astroturf by a couple of rogue MOBsters. I groaned and moaned but mostly kept it in (In the waiting room, I mean. When I was being dragged across the Astroturf by a couple of rogue MOBsters, I was shouting, "STOP! STOP! STOP!" Of course, one of them stopped before the other, and that's why I hate torque.). I couldn't even yell out curses because there were small children around. But I was determined not to be one of those obnoxious patients who come in and just keep screaming. And of course there are conditions where constant screaming is totally involuntary, and that's not obnoxious. But I could not scream if I wanted. I was in pain, but I could bear it. Mostly. No reason to bother everyone else.
I think the TV was showing The Dukes of Hazzard.
A Hispanic woman and, presumably, her daughter motioned to me. The mother said she had dislocated her shoulder before, so she knew how much it hurt. She told me I should scream a lot so that they would see me faster. The sign did say that patients would be seen in order of severity, and I certainly didn't see anyone else there who looked to be in as much pain as I was in! She and her daughter told me about a Spanish comedy show that made fun of how long you had to wait in emergency rooms: one woman was delivering a baby in line, one guy had a knife stuck in his shoulder, etc.
My uncle came in with my mom on his phone, and she asked how I was, and I said in pain. This was probably about twenty minutes or half an hour since my shoulder had come out. Before, a doctor running laps around the stadium had noticed me and popped my shoulder back in within about five minutes. That was how it was supposed to work, for me. I could not imagine why it was taking so goddamn long to do something that could be done in ten seconds.
The Hispanic mother asked if my mom had told me "no more playing." My uncle said that there was "no more playing, no more chasing girls." He said he would take care of the chasing girls from now on. I think that whole thing may have been less non sequitur than it sounds, but maybe not. In any case, I told him his girl-chasing days were over, and this was actually going to help me, as all the girls would come over all, "You poor thing!" The mother laughed, saying I already had it all planned out. My uncle said that it wasn't working on her daughter, which was unfortunate for me because she was rather attractive.
The pain was getting worse. It hadn't been so bad before, but the longer my shoulder stayed out of place, the stronger the ache was becoming. The mother said I should yell for some pain medication.
She also joked about Lethal Weapon, how Mel Gibson just pops his shoulder right back in. She asked if I could move my arm closer to my stomach. I tried, but rotating that way caused pain. She came over and sat next to me against her daughter's complaints. She took my arm and tried to gently push it toward my stomach. It hurt, so she left it that way.
Her daughter told her to leave me be. "Está frio," she said, placing her hand on mine to give it some much-needed warmth. "Pobrecita." I got a glance at her wristband, which identified her as Angelica, and I could not resist having the clichéd thought that she was, indeed, my angel.
My name was called, and boss-uncle helped me up. As I left, I threw back a "Gracias." She called back, "De nada." I love the Spanish "You're welcome" because it basically translates to "It was nothing," which is what I generally say when someone thanks me.
I walked to a window where a male nurse asked me if I would like a sling. "A sling would be nice," I said. It was funny because I had kept my sling from my first dislocation, and I could have been wearing it if it weren't packed up in a box somewhere. I came around behind so that he could put on the sling and take my temperature and blood pressure and OMG NO ONE CARES JUST PUT MY SHOULDER BACK IN PLACE.
He asked me if I needed a wheelchair, and I said I could walk fine. He led me into a hospital room and then left, telling me to lie down.
My uncle asked me, "How much is your pain, on a scale from 0 to 10?"
"This one goes to 11," I said, doubting he would get the reference. I climbed onto the bed. "Jesus Christ, that feels better," I said. Boss-uncle commented that it was because I now had more support; I wasn't fighting against gravity so much.
Then, I waited. My uncle and boss-uncle kept me talking to distract me from the pain, and I babbled on about ciprofloxacin and neutropenia because I had to keep me talking to distract myself from the pain. The nurse popped his head in to ask whether I had come here for my previous dislocation, and I said no, it was in Texas, and OMG NO ONE CARES JUST PUT MY FUCKING SHOULDER BACK IN FUCKING PLACE OMG. FIX FIRST ASK QUESTIONS LATER.
A nurse came in from the other side and asked me to keep it down and also informed us that there was a one visitor per patient rule, so if it got too loud, she would have to ask one of my uncles to leave. Keep it down? KEEP IT DOWN? I AM IN PAIN, WOMAN. My uncle was still encouraging me to scream rather than hold it in or channel my pain into nonsense.
All through this, various men and women walked in and asked me, like, the SAME QUESTIONS OVER AND OVER, and I couldn't even tell whether any of them were doctors or the doctor printed on my wristband, the one who would presumably FIX ME.
The pain was getting hard to take. "Ow, ow, ow, ow, ow, ow," I said. We saw some cops leading a guy away in handcuffs. "Ow, ow, ow, ow, jail, ow, ow, ow, ow." My uncle remarked that I would have been treated faster if I had been brought in by the police. I said I would have been treated faster if I had been shot. Could somebody shoot me?
The male nurse came in and said he was going to set up an IV so that they could give me pain medication. For this, we had to get my shirt off, which was a little more complicated now that my arm was in a sling, which, honestly, had hardly helped at all. But my uncle and I managed because damned if I was going to make them ruin my shirt to get it off me. The nurse prepped my right arm and told me I would feel a slight prick, and I told him, "Then I will just SCREAM for no apparent reason," and can you guess at what point he stuck it in? My uncle said it looked painful, and I said it was no big deal; I'd given blood before.
More time passed. I said that at least they were giving me pain medication, and boss-uncle said that they hadn't even given it yet; they had just set up the IV. It was probably sugar or saline or something.
"What?" I said. "Did they think I was going to fall for the FUCKING PLACEBO EFFECT?"
"Well, do you feel better?" he asked.
This was fucking ridiculous, I said. They were going to give me pain medication so that I could wait longer. FIX ME, SEYMOUR. It had been something like an hour since I had gotten there.
The nurse came back in with the medication. I asked him what he was giving me; now that I've studied pharmacology, I'm more interested in these things because I'm supposedly knowledgeable about what they do. He was injecting my IV with Dilaudid® (hydromorphone), an opioid analgesic, as it turns out.
I described how it felt to my uncles, who had never been on it before. It felt chilly, cold through my veins. After a few seconds, I began to feel lightheaded, as if I had suddenly become veeeeeeeery tired. My visual frame refused to stay still. I closed my eyes, so very thankful because there were tears in my eyes now; the pain was finally getting so bad I wanted to cry.
I tried to lie down, but I couldn't go back far enough. My uncle put some padding behind my neck, which felt much better. I thanked him. The nurse put a blanket over me and raised the sideguards. I could still feel the presence of pain, but it wasn't nearly as strong.
A short while later, I was wheeled away to radiology. Whee! I thought. I'm going on a trip! I didn't say it out loud because I didn't want to sound delirious. I had sounded crazy enough before the Dilaudid.
I never even got a clear look at the radiologist; I was very sedated. He asked me if I could stand up. I said...no. He said he could do it from the bed, but he would get better pictures if I could stand up. I said I could do it, not wanting to be a bother.
I got off the bed and carefully walked over to where he told me to be. I needed very precise instructions here; I felt like I'd been up for seventy-two hours straight. He told me not to move, but the pain, the pain was still there, so there that in trying not to focus on it, I caused my entire left side to shudder. I hoped I wasn't messing up the X-rays.
I closed my eyes. Boss-uncle told me to open my eyes, presumably so that I would be able to see where I was and not fall into anything. I told him when I opened my eyes, the world wouldn't stay still. It looked like a film reel being pulled downward and then abruptly stopped, the same scene shifting up and down.
We had a little trouble getting the picture of the back; the radiologist wanted me to move closer to the box, and I was trying not to hurt. When that was done, I lay back down on the bed for a while until he came back and said he wanted a couple more X-rays. Yay. I got up and did it again.
I was very tired. They wheeled me back. I was so disoriented that I asked boss-uncle to confirm that we were back in the same room.
A woman came in and informed me that I had dislocated my shoulder. OH. YOU THINK? I BELIEVE THAT IS WHAT I HAVE BEEN TELLING EVERYONE SINCE I FUCKING GOT HERE. She asked how my pain was, and I said it was still there. If it had been a 10 before, it was probably a 6 or 7 now. They'd given me 2 mg of Dilaudid, she said, which was a pretty big dose.
They were going to perform a reduction to put the shoulder back in place, and the procedure would be done under conscious sedation. She asked me to sign a consent form, and I was wary of the legality of a consent form signed under the influence of analgesia, but I signed. Because what was I going to do? Not sign? The only risks, she said, would be adverse reactions to the drugs, and they had antimeds to deal with that. I wasn't going to have an adverse reaction to having my shoulder put back in. Well, I might if YOU GUYS SCREW IT UP OR SOMETHING. But it was hard to be ragetastic when I felt so tired and wanted to go to sleep.
People kept asking if I smoked, as if that would affect anything. I guess it somehow affected what drugs they could give me. No, I did not smoke, I did not drink, I did not do drugs, and thank you for asking me all these questions in the presence of boss-uncle, guys. Lucky for me I'm clean as a whistle that is not dirty.
I think my primary doctor was this cute little Japanese woman, who helpfully informed me that I had dislocated my shoulder, and they were going to perform a reduction under conscious sedation. I was going to get Versed® (midazolam), benzodiazepine, and fentanyl, another opioid analgesic. The latter is apparently 80 times more potent than morphine.
The male nurse began ripping off the tape on my IV to readjust it, which caused me new pain.
"It's just tape," my uncle said. "And at least it's something new to focus on."
"It's external," I cried. "The Dilaudid doesn't do anything!"
My mouth felt a little dry. "Can I have some water?" I asked.
"Oh, no, you're about to get the thing," said the woman who had come in with the consent form. "Maybe afterward." I thought she was joking because what the hell harm could a little water do? But she wasn't joking. No water for me.
Versed and fentanyl entered my system at around 11:30, over two hours after arriving, about two-and-a-half hours after my shoulder had dislocated.
I woke up. I looked at the clock. It seemed to indicate that it was close to 3:00 in the morning, which didn't seem right. I noticed that I didn't seem to be in pain. I looked at my shoulder, which seemed to be round again. I sat up. If I were in a television show or movie, this is the point where I would remove that thing from my nose, whatever it was, and disconnect myself from the IV, disregarding the fact that it could be important, and walk around the hospital in a daze. But since this was real life, I did not touch the complex medical equipment and waited for someone to notice that I was awake. The male nurse finally stopped by and said he would call my uncle.
I was still very tired and a little disoriented, mostly because I had no recollection of the last three-and-a-half hours. I didn't even remember the moment I conked out. According to boss-uncle, the entire procedure took about ten minutes because my arm had to be pushed in two directions in order to get the joint back into place. And it took them a few tries to get it right. Boss-uncle was worried for me. They even called an orthopedic surgeon in, but they finally got it by the time he arrived. I groaned and moaned in pain and apparently said, "That feels better," once it was done, but I have zero memory of this. They had said that would be the case with conscious sedation, but it's still unsettling.
A man came in and asked me my name and birthday and if I knew where I was, and I passed the test (the correct answer to the third question is "Yeah"). My aunt—who the man initially thought was my wife—had come to pick me up; it was about 3:30. I was told to make a follow-up appointment with an orthopedic surgeon within the week. I was told that the first time, too, and I never got around to it, I don't think. I imagine he would tell me to wear the sling for a week and then do physical therapy exercises for six weeks afterward, which is what I was told before.
We got back around 4:00. I drank some milk before climbing into bed.
Here is a sign that working sixteen days in a row will drive you bonkers: as I was falling asleep, I reminded myself that I had had an SAE of Grade 3 anemia that was reported in the clinical study database but wasn't in the CIOMS. When I woke up, I tried to think of why I would have had anemia during my lost three hours, and then I remembered that I was just crazy overworked.
People were surprised that I came into work today, but for God's sake, the very day I dislocated my shoulder the first time, I was a gunner on the way to the stadium, and I was on the field during halftime doing my damn job. So my arm is in a sling. I can still type.