DISLOCATIONS 101: TAWE TO A&E ~ By Nick Boreham

To kick us off this week we welcome a guest post from Nick Boreham of River Stench. Check him out!

I was always intending to do a few posts on shoulder injuries, having been unfortunate enough to build a veritable wealth of experience over the years. I had even started penning an article beginning with a tongue-and-cheek account of how a friend of mine, Tom Clare, had recently found himself standing on a rock in the middle of the Aberglaslyn gorge having just suffered an injury himself. Unfortunately karma didn’t find this story amusing enough.

Goodbye forever
Tom having fun on the Aberglaslyn gorge

Usually the first thing you notice when you dislocate a shoulder kayaking is that you can’t breath and are upside down. Then you might start to notice that your shoulder feels a little weird. The act of dislocating itself is rarely painful of its own accord; rather, it is the bits that follow which are exceedingly unpleasant, something that I was very aware of and already planning for as I popped my deck and swam out of my boat on the Tawe this Friday.

Step 1: Fall off waterfall sideways

Screwing up a boof I had fallen sideways into a high brace, leading to the inevitable. This however was unimportant as the more immediate issue was that I was quickly floating into the next slide with only one arm. Now I’m not an expert at swimming down rocky slides but my experience of going to a water park with a broken arm when I was 10 has taught me that it is unlikely to be a comfortable experience. Fortunately I had my friends on hand to haul me into an eddy before I could confirm my hypothesis.

Step 2: Get out on the river.

Sat in the eddy with the water comfortably supporting my arm there were now two options: 1) Traipse to the hospital and ask politely for a professional to relocate the my shoulder or 2) Attempt to put it in ourselves. At the thought of a long walk across rough ground to the road and then an even longer drive I chose option 2. There are multiple techniques of relocating shoulders which I’ll let you Google in your own time but the key for most of them is to relax all the muscles in your shoulder and push your shoulder blades together while the arm is manipulated, until the shoulder pops back in. It is a fairly simple concept but far more difficult in practice, particularly while sat in an eddy. The matter is further complicated by the fact that there is only so long you can comfortably sit in an eddy in mid-January and with a chill beginning to build it was decided to move me out of the river and to call an ambulance to take me to the hospital.

The task of moving someone with a dislocated shoulder is not an easy one unless you are willing to subject your cripple to crippling amounts of pain. Having suffered an unfortunate incident in the Alps not too long ago where we banked on speed over caution, I decided I didn’t want to face such an ordeal again (Hint: Rally style driving is not comfortable or fun for those with dislocated shoulders, especially round roundabouts).

First off Snape prepared a comfortable foil blanket bed in a flat-ish area of grass and then we skilfully removed my BA to allow me to lie down in the closest thing to a comfortable position. Moving then entailed Dom and Veasy supporting my otherwise flailing arm while Snape helped me up and across the uneven ground towards my shiny nest. Once in the nest I was stuffed with a chocolate bar, wrapped in yet more foil blankets before being thrown in the oven. Having beaten off the threat of hypothermia and with the ambulance en route we decided that we should press on with the epic trek to the road. This was approximately 200m. Despite this fact it took us approximately 30 minutes to complete this monstrous traverse, braving bracken, twigs and at least 3 puddles that stood in our path. All the while my limp limb remained admirably supported by a tag-team of my comrades.

Fortunately by the time we had made it the few hundred meters to the road the ambulance had arrived although they didn’t seem all to impressed with the grimacing damp and muddy mess that was now struggling to clamber into the back of their vehicle. Once I was in, sat down and we had gone through the awkward process of removing my drysuit, I was attached to an ECG to make sure I wasn’t dead. Having confirmed this the ambulance crew precoded to ask me which shoulder I had dislocated and if it hurt; at this time I sat there grimacing while my right arm hung in a peculiar position. Once this vital paperwork was complete we enjoyed a sedate drive through the Welsh countryside to Swansea A&E. Unfortunately there were no blue lights.

I see you have the machine that goes PING!

Now you may be wondering if all this faff is involved with an ambulance, why bother? Yes, you could indeed drive yourself and arrive sooner. But there is one thing you don’t have in your car (unless you make your own whipped cream), a copious supply of gas and air. Nitrous oxide, commonly know as laughing gas, will make the journey a lot more tolerable for the invalid in question, and give them a good chance to work on their Darth Vader impression.

By the time everyone caught up with me in the fracture clinic I had more or less perfected my dark lord imitation, however my growing allegiance to the dark side of the Force had not inspired contact from any of the hospital staff. I could now talk about how the NHS is being underfunded, the immense pressure being placed on junior doctors and how the whole system is being set up to fail so it can be sold off. Unfortunately this is of little condolence while lying in a hospital bed and instead I amended and read a document entitled ‘Why I have to wait’ to my captive audience. With arm now attached purely by my increasingly sarcastic sense of humour, search parties were sent out to find nurses, food and beer (although not necessary in that order). The result of this was only bad news. First, there was a Subway on site but I couldn’t eat until I was discharged. Overshadowing this though was the small issue that according to the system I was still in the back of an ambulance! Worst of all, there was no beer!

Owing to Tom’s investigatory skills, I was ‘moved’ into a bed despite having been in one for 2 hours and then bumped up the priority list so I could be removed from said bed. Once you have been seen in a hospital the process of seeing to a dislocated shoulder can be less than 45 minutes. 1st an x-ray is taken to prove your shoulder is dislocated, then everyone agrees that it is dislocated, the shoulder is relocated and then a final x-ray is taken so the doctors can admire their good work. The doctor working on my shoulder this fateful Friday was a young junior doctor and it was her first relocation.

Something is not quite right with that shoulder…
Something is not quite right with that shoulder…

Now I have been reliably informed that I took a small liking to this doctor, a fact I can neither confirm or deny. I was glad to finally be seen to and have my shoulder popped back in. Although Tom put it as: “Stopped being a whiny sarcastic bitch” and “chirped up a remarkable amount”, all I remember is getting a good laugh when I stated that ‘a chocolate bar’ had been my only pain medication!

Learning medicine seems like a daunting task far beyond me and, from living with a medic for a year, quite stressful. Luckily for the junior doctor that day, both the nurse and I were experts in the procedure of relocating shoulders which consists mostly of massaging, laughing gas and a healthy bit of tugging to achieve the relieving moment where everything finally clicks back to how it should be. The moment where your shoulder is relocated after several hours is perhaps one of the greatest feelings in human existence (that said it’s probably not worth the hassle of injuring yourself in the first place). I’d like to thank all of the NHS staff and volunteers who helped me and more impressively managed to put up with me being a “whiny sarcastic bitch”. I swear it was the gas…

Shoulder now relocated and everything is okay with the world.
Shoulder now relocated and everything is okay with the world.

After almost 4 hours in the hospital we had my final set of x-rays, took a couple of pictures, managed to grab a subway just before it closed and headed home. We did however miss the uni club’s pool session that we were all supposed to be attending and the trip to Ocean following it (sorry).

Again thanks to all the staff, volunteers and my friends who all did a great job helping a stupid muppet.

Written by Nick Boreham, kindly edited & corrected by Matt Brook.

Check out Nick’s Blog River Stench, and Facebook Page

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