I suffered my first shoulder dislocation in 1996 as a result of some skiing stupidity. I was at a small resort in Switzerland called Engelberg. The accident happened because I stupidly did not slow down for a drop of a few feet that ended on a flat cat-track. As a result of my speed and sudden deceleration, when I relexively put my arm out to break my fall, the force took it out of the shoulder socket. It being Europe, there was no helpful ski patrol, and I ended up having to ski down, part of the way on a black slope, to the base area, only to be told that I needed to take the shuttle bus into the village to find the doctor. Well, needless to say, it was getting rather painful by this time, but I reached the doctor's office, who helpfully, could speak english, fortunately. After some careful maneuvering to get out of my ski clothes, they reset my shoulder without anesthetic. Let me tell you, the pain miraculously goes away once the shoulder pops back in.

After some period of rest, recouperation and physical therapy, things seemed to be fine. And in fact, things were fine until 2000. It was at this time that I decided to get into indoor rock climbing. Did some training climbs and then decided to tackle something a bit more difficult. OK, you know what's coming up. On one particular move, it required me to reach for a hold an support much, if not all of my body weight. A "dynamic" move, they call it in climbing lingo. As my shoulder was suddenly called upon to support said weight, it decided to let go of my arm bone. Needless to say, after this happened, I immediately got myself lowered to the floor, unharnessed myself and got driven to the hospital, where they gave me a fentanyl IV to sedate me and reset my arm.

I was still in a state of denial about the severity of damage to my shoulder, and didn't consider surgery at that point either. I did decide not to climb again though. Fast forward another year. I am scuba diving. Actually, just preparing to dive, on the surface. As I bring my arms over my head, my shoulder comes out. Of course, I abort the dive right there and get back on the boat, where I am able to reset my shoulder. I should mention at this point that with the previous three dislocations, the head of my humerus was severely dislocated, to below my clavicle. The dislocation that happened on this scuba trip was only a minor displacement, so could be more easily popped back.

Now I was more worried about my shoulder, especially after it popped out two more times doing nothing out of the ordinary in the following weeks. It was definitely very loose. Coincidentally, a colleague at work had just had shoulder surgery himself, and recommended his surgeon. I was interested in getting arthroscopic surgery, rather than the traditional open surgery, and Dr. Wolf was a pioneer in this area, so I went back to see him. The appointment was a mere formality before the scheduling of the operation. His nurses teased me a bit about my now being brave enough to face surgery, considering I had wimped out earlier.

Some weeks later (Dr. Wolf is fully booked with shoulder and knee surgeries), I went to the outpatient surgery office. I had to strip down to briefs and then put on the hospital gown and a "shower cap" and booties. The anesthesiologist came by to check me out, then I was put on a valium drip. I vaguely remember being wheeled towards the operating room, but next thing I do remember is waking up. The nurse asked me if I felt ok, and I said that I wanted to sleep some more. Which I did. Some time later, pretty much on the schedule they told me to tell the person who was picking me up, I was awake and ready to leave.

My shoulder was wrapped in a thick layers of dressings, which I was told to keep on for 24 hrs. I also had a prescription of vicodan. I found that I was most comfortable in a slightly reclined position, and could not lie down without pain. Later, I figured out that when you lie down on a normal bed, your shoulder is not well supported, and thus the arm bone is affected by gravity against the shoulder socket. I slept in this semi-reclined position for a some weeks. After the 24 hrs passed, I took off the dressing. It was full of dried fluid, and I could directly see the incisions. I had four incisions, radially around my shoulder, tied together with stitches. The post operative painkiller had worn off by this time, and I was popping vicodan periodically, once the pain got to be really annoying. Basically, the pain wasn't agonizing, but it was a very uncomfortable throbbing kind of pain. The vicodan basically put me to sleep, so my life for the next few days was: wake up, watch tv/eat/whatever while the vicodan still had its effect (a number of hours), then, after the pain had built up again, pop a pill and fall asleep. I also used a cooling device that consisted of a pump that recirculated cooled water kept in a modified cooler, through a pipe that was attached to a flat-ish plastic sheet that had a network of tubes to spread out the cool water. This was to help cut down on swelling, and ease discomfort. It worked pretty well.

After 3 days, I went back to work. By this time, the pain was pretty low level and tolerable. My arm was to be kept semi-immobilized in a sling. It was to remain that way for 6 weeks. After 6 weeks, physical rehab began. This started with stretching exercises. In the beginning, I had a very limited range of motion, but slowly, the range of motion was regained as the ligaments were restretched. After a couple of months, light weight work was added. It's now been a year, and the arm is pretty much back to normal, with no noticeable decrease in range of motion.

As for the operation itself, it was a combo operation that apparantly was written up for a medical journal. Dr. Wolf did two things. One was a Bankart repair, which is a technique to reattach the main connective tissue back onto the supporting shoulder bones. The other was a repair of what's called a Hill-Sachs defect, which is a notch in the humerus caused by the shoulder bone as the humerus rolls out of the socket. This existance of this notch can cause post-operative dislocations if not addressed. This was repaired by attaching part of the connective tissue to the humerus to cover the defect (this is, at least, my layman's understanding), and theoretically, it reduces my shoulder's range of motion, but I don't notice this. In any case, doing both these procedures together, arthroscopically, is a pioneering technique. I was apparantly number 4 or so, and the pictures of my shoulder during the operation are to be in the aforementioned medical journal article.

My colleague who had an open surgery Bankart repair ended up having a post-op redislocation. Most dislocations are anterior, aka "out the front", but his post-op dislocation was posterior. According to Dr. Wolf, this is much harder to fix, and it is one of the reasons he doesn't like the open surgery: the open surgery opens the front of the shoulder. The surgeon usually fixes what he sees, so in this procedure, whatever is damaged in the front of the shoulder is fixed, but any damage to the back of the shoulder is unnoticed, let alone fixed. This asymmetry is what causes post-op dislocations -- the front of the shoulder is tight, the back not so tight, so with the proper (or improper) application of force to the shoulder, the back gives way. With the arthroscopic procedure, "surgical portals" are opened all around the shoulder, so the whole shoulder can be seen. In fact, Dr. Wolf told me that once I was "opened up", there was more damage than was initially anticipated, which he, of course, fixed.

So in conclusion, I have to give my wholehearted recommendation to anyone reading this who needs shoulder surgery to Dr. Wolf. He did a fantastic job for me and my shoulder is working fine (knock on wood). I have given up climbing for good, and while I haven't tested my shoulder with out of the ordinary activities, I think it is 100%.