Tuesday, October 7, 2014

Injuries

And now, in the less distraught world...

I've been injured fairly seriously twice in the past year.  I tore a tendon in my wrist and I nearly decapitated two of my fingers on my left hand.  Oh, and now that I think about it, I broke the pinkie on my left hand (in an entirely separate accident).  Physical pain is almost trivial at this point, I practically forgot that I broke a bone.  Which is not to say that I've broken many bones, but over the course of my relatively short life, I've actually had a lot of physically painful injuries.

When I was younger I sprained my left ankle three times in one summer and my right ankle twice.  I was out for less than a week for sports each time.  I iced, took advil, taped my ankle and was back a few days later.  That's just how I handled pain, even from a young age.  I think I was eleven that summer.  I did end up wearing ankle braces for several years after that while playing soccer, because my ankles were weak, but it wasn't a big deal.

I think my first truly serious injury, at least in my mind, was I had a second degree tear of my right MCL, which is the medial ligament in your knee.  I was a freshman in high school and playing on both junior varsity and varsity for volleyball.  During practice with JV, I went up for a block and the middle hitter on the other side of the net went up to joust with me .  As we came down, she came under the net and bumped into me.  I landed on the heel of my right leg, which hyper-extended and twisted, tearing my MCL.  I went to the trainer, she told me the probable diagnosis, gave me some ice, and wrapped my knee.  I think I was one crutches for a day, maybe two.  It was my first and only time on crutches.  I wore a borrowed brace that entire time.

It took me nearly two weeks to recover.  Never in my life had I sat out for so long.  In fact, I think that's the only time I ever just couldn't practice.  The pain was always completely manageable, but what scared be was the instability in my leg.  I would sometimes just take a step and, even with a brace, my knee would start to buckle and hyper-extend.  To this day, that tendon still gets sore in I spend too much time in a position where my knees are bowing in (for instance focusing lights in box booms).

Playing club volleyball that winter, I cracked ribs on the right side of my body.  I dove, got the ball up, but landed too hard on my ribs.  I didn't hear them crack the first time, but even breathing was painful.  I, being the stubborn idiot I am, never even missed a play that day.  The last vestige of pain from the injury I remember being fall of my senior year.  I re-cracked them at least twice.  I know at the Reno National Qualifier I re-cracked them.  They were almost healed, but then, sophomore year, shortly before I injured my shoulder, I was passing a ball and the teammate in front of me reached back to play a ball that wasn't hers.  Her fist went right into my ribs and that time, I actually did hear them crack.  I think that was the only time I ever swore on the court or field (not that I think anything of swearing these days).

I have an entire post devoted to my shoulder injury.  But in short, during practice my sophomore year of high school, I came down from a block and then my teammate came down after me and her elbow collided with my collarbone.  I ended up with impingement from that immediate encounter (which again, the trainer at my school diagnosed correctly (it took orthopedists 5 years to believe me)).  I think my grandparents were the only ones who realized quite how chronic my pain was.  There were times when I couldn't jump serve, particularly after a long tournament, it was just too painful.  I abused advil to no end.  I think at it's worst, I was taking five advil to cut the pain.  I switched to another pain killer and still couldn't get a doctor to believe that I was in pain from a serious problem.

By the time I convinced an orthopedist I wasn't faking, I had not only impingement, but bursitis, a torn labrum, a 33% tear of my rotator cuff, and multi-direction instability in my tendons, meaning they had to shorten them all.  I was in a sling for two months and then not even close to recovered until two months after that.  I am daily thankful that the surgery fixed everything.  I knew I was in constant, chronic, relatively severe pain, but I didn't realize what a drain it had been on me till it was gone.

From there, I didn't have any injuries for quite awhile.  Stage management isn't exactly the most dangerous profession.  A few months after I started at Starbucks, I developed carpal tunnel.  It wasn't painful at all, but my hands went numb, which is mildly terrifying when serving boiling beverages to people.  I got a brace and that seemed to fix matters, but then, nearly a year later, I was working 80-90 hours a week between the two jobs and, during an easy pull (bringing in scenery on the counter-weight system), my wrist was just suddenly agonizing.  I taped it immediately and then added more tape and more tape.  It helped, but not nearly enough.  I added my wrist brace over my tape and that seemed to help.

I couldn't do anything without that brace.  I slept in it, I worked at Starbucks in it, and when at the theatre, I taped, used a sleeve, and a brace.  I started developing problems with my right shoulder because I was trying to compensate for my pain and limited mobility.  I'm fairly certain, that if I hadn't found a solution, in relatively short-order, I would have torn my rotator cuff, this time in my right shoulder.  It was affecting my work enough that my co-workers were starting to worry about me.  Completely honestly, the pain and repetitive strain on my wrist and shoulder is why I quite Starbucks.  Like my shoulder, the pain was chronic enough and severe enough that I was worried this injury wouldn't heal on its own.  I went back to my orthopedist and he sent me off to do a nerve conduction study, thinking it was still a strange version of carpal tunnel.  I doubted his diagnosis (surprise), having done a little research, but off I went.

The study revealed I had moderate carpal tunnel, but not enough to account for my pain.  When I went back to my orthopedist I finally convinced him to focus on the ulnar side of my arm, where the pain was (as opposed to the radial side, where carpal tunnel usually manifests).  He realized I had a major tear (I could stick my index finger in the gap between my carpals and metacarpals, one of the tendons was basically severed) in my TFCC (triangular fibrocartilage complex) and gave me a cortisone injection in the joint.  For two days, my wrist was virtually unusable (I also had the flu that weekend, so I was just completely miserable), but after that, my wrist clearly started to heal and now it's completely better (I thoroughly appreciate ligaments and tendon that can heal, even when basically severed).

The wrist injury was November to February.  In April, I broke my pinkie finger while moving a set piece.  The stupid actor I was working with knocked a heavy ship's steering wheel off the piece and it fell on my pinkie.  I didn't hear anything break, but I looked down and saw it was crooked.  I straightened it, threw on a pair of gloves, and finished my last six curtain pulls of the night (unfortunately, I was literally the only person who could do them).  The pain didn't really kick in until the curtain pulls, I think it was entirely shock up until that point.  Again, I'm an idiot, and didn't go to the doctor.  Ultimately, they wouldn't have done anything for me that I hadn't already done.  I splinted it, iced it, took pain meds, and drove myself home.  When I injured my left hand later in the year, xrays confirmed that I'd broken my pinkie.  I don't really regret my actions too badly.  My pinkie bends and straightens normally, with only slight stiffness, which is increasingly less.

I got through my entire next show without an injury (two minor pulled muscles, but those hardly count), which is fairly amazing because I've never worked so hard in my entire life.  It was the show that I was assistant stage managing (my first actor's equity contract), where I almost lost the tips of two of my fingers.  I came into rehearsal and started my usual prep, I needed to make coffee, hot water, make copies, and fill up the water pitcher.  Someone had propped one of the heavy 4'x8', metal framed windows open with our water pitcher.  I went to reclaim it, vaguely wary of the window, having dealt with them before in the other rehearsal room.  Well, in the other rehearsal room, they don't just slam shut when unpropped.  This window did.  I went to hold the window up with my right hand and take out the water pitcher with my dominant left hand.  As I'm sure you've guessed, the metal window slammed against the metal frame, and caught my left index and middle finger.  I'd had time enough to pull them back a little (probably what saved them), but not enough.  I remember yelling wordlessly, not because it did hurt, but because I knew it was supposed to.  I stood there for a second, clutching my fingers, instinctively applying pressure before I even realized I was bleeding.

I think I scared my stage manager and director more than I scared myself.  My director was screaming "Oh my god, are you alright?! Are you alright!?!"

I remember managing something like, "I think I'll be okay. I just need a second."  It was then that I looked down at my finger and realized that no, I really thoroughly was not alright.  Blood was all over me, mostly contained by my right hand which was still applying pressure.  I ran to the bathroom, going through the stage management office, to alert the sm, to get there.  The stage manager and director followed me from a distance, completely shocked and unsure what to do.  I got to the bathroom, grabbed paper towels and clamped down on my fingers as hard as I could.  At this point the full pain had kicked in.  As it turns out, when I'm in that severe and acute of pain, I cry.  I can't help it.  It's like getting hit in the face with a soccer or volleyball and your eyes start to water.  Except in this case it was more than watering.  Having dealt with a hand injury before, I knew that I would probably pass out if I stayed standing, so I knelt by the sink, so the blood that seeped through the towels would only get in it and not on the floor.

The stage manager called my mom, who immediately knew something was wrong when my voice wasn't the one she heard at the end of the phone.  After a few minutes, I had the bleeding stopped mostly and was able to talk to my mom.  I remember my voice shaking and hating it, but not being able to stop it (much like the crying).  I tried to wrap gauze around my fingers to bind the paper towels in place, failed miserably, and the stage manager finally had the presence of mind to help me.  The director had gone off in search of our boss, who wasn't on the premise, and when he came back I informed them that I needed to go to urgent care and he took me.  I has prepared to drive myself.  I would have done it and I'm fairly convinced I would have been okay, but it was smarter that he took me.

I had the world's worst receptionist, who tried to make me fill out L&I paperwork with my non-dominant hand while in the the worst pain I'd ever experienced (which was saying something).  Needless to say, it didn't work out so well.  I finally dictated to the director what needed to be written.  While he was filling out the rest of the paperwork I was called back and had a nurse look over my fingers.  Now, understand, the pain was radiating, it was extremely hard to tell which fingers exactly were affected.  I'd wrapped the index, middle, and ring fingers; turns out the ring finger only had a minor bruise.

But, when I got in there my conversation with the nurse went something like this: Her: "Nice wrap job...." (extreme sarcasm I will swear to the death I did not imagine). Me: "Well I had to stop the bleeding and it's what I had on hand!" Her: "Well it works I guess.  What fingers are hurt?"  Me: "I don't know. It's hard to tell.  The index and middle fingers.  Maybe the ring."  Her: "Have you have a tetanus shot in the last seven years?" Me: "I don't remember."  Her: "Well I need you to remember." Me: "I'm not in the best condition to remember much right now, I'm sorry."  Her: "Well I don't care what kind of condition you're in.  I need you to remember."  Me: "Look, I'm sorry, but I don't.  Just give me the tetanus shot."

The dull ache of the tetanus shot reminded me that I'd had a shot five years previously, but oh well, no harm done.  In retrospect, I should have had them do the tetanus shot in my left arm, even though it was dominant, because it's not like I was going to be using my left hand any time soon.  Luckily that nurse left at that point and didn't come back.  My mom showed up and they gave me some numbing gel, which helped some.  Then they gave me pain pills, which I swallowed dry, because I was too impatient for them to fetch water.  They took an xray and shockingly, nothing was broken.  They cleaned the deep cuts on both sides of my index finger, which (aside from the cut itself) was the most painful procedure that I experienced that day.

On my index finger, I had a cut that ran to the bone on my palm side and a cut running parallel to the other one, almost to the bone on the back of my hand.  As the doctor told me, I was extremely lucky that I didn't lose the tip of my finger, which would have been awful, because it would have sliced diagonally through the joint.  I got five stitches on the palm side of my index finger.  She would have stitched the back of my index finger too, but there wasn't enough skin to work with.  My middle finger was more crushed than cut.  I had a very shallow cut, but more painful was the blood blister that formed under the nail.  The doctor burned a whole through the nail and let the fluid drain, which also immediately relieved the pain.

It's been almost two months now and my fingers are mostly healed.  I had bad damage to the nail matrices of both fingers, so the nails are growing out a little weirdly.  Surprisingly, the cuts to my index fingers barely have visible scars.  There is a lot of scar tissue present that I'm trying to loosen as time goes by.  But unless something strikes the scar just right, there's pretty much no pain anymore.

~*~*~*~*~*~*~*~*~

So why all these stories?  I don't know, really.  The other day at costco I saw a mother just wailing because her small son had fallen and skinned his nose.  At first the little boy wasn't even crying, but as his mother flipped out, he got more and more frightened and was shortly inconsolable.  It mostly reminded me how some people just freak out over minor injuries, and I guess it makes sense.  If you've never had an injury, if you've never had sports medicine or first aid training, then I guess it makes sense why you might freak out.

I tend to underplay my injuries and pain, not really because I'm trying to be macho, but mainly just because I need other people not to freak out.  I function well while in pain, but I frequently still need help from other people.  And also because I have an extremely high pain-threshold (in case you haven't noticed).  This is helped immensely by the fact that I don't swell almost ever.  I get some heat in my injuries sometimes, but not always.  No swelling means I heal quickly and much of the pain people feel is caused by the inflammation in the injury.  I think it's part of the reason that my fingers were so shockingly painful, because I got the full brunt of the nerve damage and actually injury, inflammation didn't really play into the picture.  So, coming from this perspective, it's fascinating to watch and help people with their injuries (and from treating all my own, I'm pretty decent at treating injuries).

I don't think of myself as clumsy, though probably more careless than necessary would be accurate.  I have had a lot of injuries...10+ sprained ankles, so so many pulled muscles, pulled hamstring +2, pulled quads +2 (in a different category because hamstring and the like are more debilitating), pulled gluts, pulled hip-flexor, countless jammed fingers (every joint at least once), 5+ sprained wrists, rotator cuff tear, impingement, labrum tear, bursitis, tendon and ligament instability, torn ulnar tendon, torn MCL, cracked ribs, broken pinkie, severely cut and crushed fingers....yeah...we'll go with careless.

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