In 2009 I was 62 years old. At an evening event held in the most exclusive part of Diamond Head, I was at the UH Cancer Center director’s house for a gathering and presentation from a Nobel Prize winner. The evening was enjoyable, informative, and entertaining until my friend and I started walking back to the car after the event had ended. In the pitch darkness of the night and fueled by one too many, I fell over a boulder of asphalt that separated the walkway from the car parking section. I favored my right shoulder in the fall, avoiding using my hands while protecting my head from the direct impact with an unforgiving, solid pavement. My right shoulder and rotator cuff met the ground simultaneously with a reflex muscle contraction completely tearing 3 tendons and partially tearing the 4th. Unfortunately for me, there are only 4 tendons in each of my two shoulder rotator cuffs. Moreover, as shown on my magnetic resonance imaging study, in addition to documenting the tears, it was determined that the quality of the tendons of this 62 year old who was addicted to playing tennis, serving thousands of serves over a 35 year period, was marginal at best….they were described as looking like dirty shoe strings.
The best orthopedic surgeon in town gave me less than 20% chance of recovery! So, I flew to NYC to find one of the most famous shoulder surgeons in the world. He walked in with his perfectly shined $500 shoes and had his assistant do all the talking. Less than an hour in the operating room, they put humpty dumpty back together again. Fast forward 14 years, my right arm and shoulder are strong and pain free, with an amazing range of motion that any 76-year-old would be ecstatic to own. What a lucky man, I was instantly deflated by the prognosis I received from my local orthopedist, but somehow by the grace of God, I was given another chance at full function of my arm and shoulder. While I ultimately should have had the common sense to avoid this fall, the absence of illumination of this Diamond Head common walk and parking area prompted the neighborhood association to offer me enough funding to compensate me for the out-of-pocket expenses in seeking a remedy at the famous Hospital for Special Surgery at Cornell Hospital, New York City. I was happy to accept, and they were happy to get off so lightly- no pun intended.
The mind is a powerful thing….. there is no limit to its potential. One’s body is another story. No matter how hard you try to keep in shape, time will slowly degrade your physiological and anatomical infrastructure-both from inside out and outside in. At first like a termite infestation, you won’t notice it. But then you push on the wall, the baseboard, the floor, and its either soft or it collapses to the touch. With the human body over the age of 40 years, tendons weaken as muscles lose their strength and with age and usage, and if you fall with outstretched arms or bluntly on your shoulder like I did, there is a good chance that you will injure, or possibly fracture your rotator cuff tendon(s). Indeed, the prevalence of rotator cuff tendon tears (RCTT) in one study of the public at large was 22.1% overall, increasing with age and non-existent in the population under 40 years of age. It is interesting that more than half of those with RCTT were asymptomatic.
What is also interesting was my perception before and after the injury. Yes, I have two arms and two legs, but they were simply taken for granted. I never individually regarded my body parts whenever I achieved anything of physical import; my limbs were commanded by higher forces, and they obeyed. But after my injury, I could not control my arm to perform certain functions. I could not raise my hand and arm above my head and there was constant pain and inflammation, serving as a constant reminder of my injury. How frail the human body, with skin easily bruised and impaled, limbs that are connected by strings easily breached, and bones that withstand only modest tension before breaking.
What is the purpose of dredging this unfortunate experience from the recesses of my mind? Two weeks ago, as I have done for decades, I was walking down my driveway on a particularly nasty, rainy day to fetch my mail from the mailbox, taking heed of the rain and walking cautiously. My driveway emerges from the street reaching my house with approximately a 20-degree incline, so walking in the opposite direction carries some small risk I have managed to avoid for 26 years since moving to Manoa. Not on that day. Too much rain and it felt as if I was hit in the ankles by a baseball bat – both feet slipped simultaneously off the pavement instantly plummeting my torso to the ground, landing on my padded derriere while also hitting my left elbow to the ground ostensibly jolting it upward toward my shoulder and rotator cuff. While shocking to me that I could experience such an uncontrolled fall while creeping along my driveway, I expected the pain and discomfort in my arm, elbow, and shoulder were minor and would abate with time. But it didn’t.
On Monday after a three-day weekend, I called the office of my orthopedist, Daniel Lim. By 11:30am I was in his office being examined, X ray in hand, and scheduled for an MRI of my left shoulder for that afternoon. A full thickness tear of my supraspinatus tendon was found to my horror. I am scheduled for surgery in two days, just 2 ½ weeks after the initial injury! I only wish I could push back the clock before my injury or move the clock forward 6 weeks to avoid the postoperative recovery period which I’m still hallucinating will not be too unpleasant.
Thank you, Dr. Daniel Lim, for your patience and concern. You have been the bright spot on this unfortunate moment in my life.
What is amazing to me is not that I have had injuries in my life. I certainly owned the medial meniscus tear of my right knee after relentlessly playing tennis at every free moment I could muster in the 1970-80’s. But I also ran races and marathons, skied while reaching speeds of 30-35 miles an hour, swam sometimes in treacherous waters, competed in ballroom dancing for the last 15 years, and walked carelessly for 3-5 miles/day at Ala Moana Beach Park for the last 10 years. While I have had aches and pains, my injuries have been self-limited and eventually healed. So, to experience the most serious injuries of my life from an otherwise innocuous activity makes no sense. I should at least have had a more exciting story to tell about this latest tendon tear. Yes, I’m nervous about the upcoming surgery.
And now that I have injured both right and left shoulders in my life, I’m hoping that I have paid my dues and can enjoy the rest of my life walking, dancing, skiing, and swimming with strong arms artificially glued together with string and anchors. I am again reminded of, and thankful for the amazing advances in medicine and the kindness and expertise of those engaged in healing other humans of their ailments. For this expertise and dedication, I do not take for granted.
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