How to do Things with a Severely Broken Shoulder (Caution: X-ray and Bruising images are shown)

A little over three weeks ago I slid down a slippery hill in my back yard, did a standing somersault on the edge of a retaining wall which broke my shoulder, then slid face first off the edge of the retaining wall a few feet from the bottom and face planted into several very large and empty plastic flower pots.  The second impact seems to be what jammed the broken long bone of my arm into the severely broken and displaced head of the bone which forms the shoulder socket. There are multiple breaks within the head of the shoulder socket and the specialist said he could not do surgery on it due to there being too many pieces.  Fortunately things are lined up fairly well.  I will have a shorter arm with less mobility but it should be pretty functional for every day activities.  I also scraped my cheek on the flower pots.

I have learned things the hard way and I hope to pass along information that might help someone else.

TIP NUMBER ONE:  Find these helpful items in your closet, your family's closet or send someone to the thrift store to find them.  You will need pull on pants (or pull on skirts for ladies that prefer them).  You may need a size larger than normal.  By about the third week-or when the pain is gone enough to be off pain medication completely- you will need pull over shirts or button down shirts that are 1 to two sizes too large.  You will need the extra room to enable you to dress yourself and to allow for some swelling that will still be present.  After reading my dressing tips below you may want someone to immediately sew the specified shirts for you or purchase the online adaptive shirts.  You will only need these special shirts for the first three weeks so don't go over board and get more than the bare minimum.

TIP NUMBER TWO:  See if your doctor can order you a swathe sling.  The emergency room made a makeshift one for me by putting my arm in a sling, then wrapping several large ace bandages around me.  The sling kept shifting downward, the velcro rubbed on my neck, and the ace bandage wasn't as secure as a swathe sling.  Plus it covered part of my arm where I needed to cold pack it so I never felt the cold getting through.  It also made me very hot.  I saw an orthopedic surgeon 3 days after my injury and he ordered and had the swathe sling on me by the next week.  It made my arm so much more secure which decreased my pain. He wanted to throw the first sling and ace bandage out but I didn't let him because I needed to wear something while I hand washed and air dried the swathe sling.  That needs to be done fairly frequently.  It took at least 12 hours to dry so I would wash it right before I went to bed and use the original sling and ace bandage wrap to sleep in.

TIP NUMBER THREE:   Do not attempt to undress, shower and re-dress all in one session.  You can undress and shower at once but I highly recommend that after drying off you put on a bathrobe with your good arm in the sleeve and the rest of the bathrobe pulled around you.  My bathrobe has ties inside as well as outside and I was completely covered up.  I sat down and relaxed for a half hour before getting dressed and then I relaxed awhile longer before attempting to do something with my hair.  There is some pain in each of these steps and you will over do it by trying to complete everything at once  Dressing is especially hard and painful so relax before you get dressed.

HOW TO GET DRESSED:  This was the most painful thing for me to do during the first three weeks.  Frequently I would get lightheaded and nauseated and nearly pass out from the pain.  I finally figured out how to do this and I seriously hope it helps you. 

• Ladies and possibly gentlemen-If someone you know can do some simple basic sewing (I managed to do this myself one handed because I sew and quilt), have them make several of these simple shirts for you.  I have provided a link.  It is basically a large rectangle with a hole in the middle and ties on the side that wrap to the front and the back.  What a relief to not have to lift my arm slightly or sneak bunched up fabric from a t-shirt under my arm.  I needed help with the ties that were around my waist so if you need to get completely dressed by yourself, this may not work for you.  I was happy that the only help I needed was with the ties.  I have two daughters so I was comfortable asking them to tie the ties for me.  I actually recommend that you make this shirt immediately-POST HASTE-it is a must!  It is similar to a hospital gown in it's simplicity, but it is short so as to just be a top and you can go out in public wearing it. Unless you are plus sized your sides are never exposed because the shirt completely wraps around you,  If you are plus sized you can just add several inches to each side of the rectangle of fabric as you are cutting it out. For men I would suggest using a masculine fabric such as plaid or camoflage.  The tie in front makes it look a little feminine but it might be worth it if it is made in a masculine fabric and eliminates the pain of dressing.  I was so happy the first time I dressed myself with the shirt and realized I didn't have to be painful when getting dressed.  For reference, I typically wear a woman's size large top and this pattern would easily fit an XL and maybe a 1X without needing extra fabric.   http://blog.hartsfabric.com/retro-inspired-wrap-shirt-tutorial/
• Gentlemen and possibly ladies-you can adapt an over sized t-shirt by cutting the side seam on the affected side.  You can also cut the underside of the sleeve if you desire.  Sew hook and loop tape (Velcro) into the cut side and it now closes on the side.  I opted not to do this because my arm was so swollen and painful that I could not even fit my hand under my arm nor let someone else do it for me to fasten the hook and loop tape.
• Search online for adaptive garments or shoulder shirts.  They have already been made with velcro in the sides.  I couldn't justify the expense for the short amount of time I would be wearing it especially since I thought it might be too painful for myself or someone else to try to fasten it under my arm.
• Once the swelling goes down enough to wear standard shirts and the pain is gone (at about 3 weeks) you can attempt to wear button down shirts or over sized knit shirts such as t-shirts that are over sized. For pullover shirts, put it on your affected arm first.  It is helpful to lay the garment on a counter top so that none of the weight of the shirt pulls on your arm.  Once you manage to get the garment to the top of your arm (which takes a lot longer than normal) you may find it helpful to hold the shirt high on your arm by grabbing the fabric with your teeth.  Otherwise it wants to slide down the arm.  Now you can use your other arm to find the remaining armhole and neck hole.  Once you have positioned your good arm in the shirt enough that it won't slide down your affected arm, you can let go with your teeth and place your  head through the hole.  Lastly, put your good arm through the armhole.  To remove the shirt, stand near a counter top.  Grab the back of the neckline and pull your head out of the shirt first, then your good arm.  Gently pull the fabric down your affected arm making sure the garment is resting on the counter top so that the weight of the garment is not pulling on your arm.
• Ladies-putting on a bra is very difficult.  There are some YouTube videos that might be helpful.  I found it easier to go bra-less because the make shift swathe sling and the real swathe sling covered me in front so that I wasn't self conscious.  I do recommend using cornstarch based baby powder on your skin to keep the moisture down.  By week three I could bend over and place the bra over my back so that the back closures were on my sides near the front.  Then I used my good hand to reach around the front and grab the end closest to my affected side and shove it under my affected arm where I could hold onto it with my arm while getting the other end stretched around my good side.  Then I could stand up again.  There was still a large gap between the ends of the bra so when I got the edges pretty close together I would use my good hand (while still holding the side of the bra from my good side) and grab the other end of the bra to shove it into my affected hand.  I hope that makes sense.  I am holding both sides of the bra closures in one hand long enough to re-position the one from under my affected arm into my affected hand. I tried holding the end of the bra in the hand on my affected side and pulling it all around me, but there was too much tension pulling on my arm, so initially pulling on it while it was tucked under my arm, let me get close enough to grab both ends in one hand and reposition the ends into separate hands. I could then hold one end of the bra in each hand and fasten the back.  Now you can slowly work the bra around to where it needs to be.  Put your affected arm into the strap first of course.

My three week x-ray showed enough new bone bridging the fractures that I could bend over without pain.

• Because you are wearing comfortable clothes you may need to consider sleeping in them during the first three weeks of recovery when dressing is very painful.  That means you have cut your dressing sessions in half-unless you sleep in undies or nude, then by all means go for it.  Undressing is way easier than dressing.

HYGIENE TIPS:

• Underarms-If your upper arm is broken and swollen you will notice that it is difficult to get to the underarm area to wash. The fracture puts off a lot of heat for the first several weeks making you sweat more. You will need to be diligent in sliding a soapy wash cloth under the affected arm and inching it into the underarm area.  You will need to do this many times in a row to ensure there is no odor.  I was not able to use standard deoderant for many weeks due to the swelling but I attempted to spray deoderant into the tiny gap I could see when I looked in the mirror.  I don't honestly know if any deoderant went under my arm for the first few weeks but it felt like a little bit did. 
• Teeth-it is pretty easy to brush your teeth with one hand but make sure you have the pre-strung flossers.  Mouthwash is difficult because it is hard to open the bottle.
• Itchiness-the heat from the swelling made my inner arm and inner side of my chest very hot, moist and itchy.  For some reason the hospital did not tell me this, but my orthopedic surgeon told me I should have a cloth under my arm.  I used just a wash cloth in between the inside of my body and inside of my arm, all the way up to my underarm, on top of my clothes and this cut down on the amount of heat I was feeling.  I purchased a large makeup brush from the dollar store, put a lot of cornstarch based baby powder in a container that was easy to open and applied the baby powder to my skin everywhere on my side, the near side of my arm, the inside of my elbow and I squeezed the brush and powder all the way into my underarm. The brushing soothed the itch, as did drying the area with the baby powder,  About 2 1/2 weeks after the fracture I had a most intense itching of the bruised areas.  I had never heard of this but after researching it I found it was common with severe bruising.  The bruising was too tender to scratch and it was too difficult to reach the area without causing pain.  The itching prevented me from sleeping.  It was driving me insane.  I bled extensively under the skin after my fracture.  It didn't even show up as bruising until 1-2 weeks later.  It is theorized that when there is an extensive amount of blood the extreme amount of bilirubin being broken down by the body from the red blood cells is responsible for the itch.  I had some Arnicare gel 7% which appeared to be the same thing as the Arnicare bruise cream (both of which are available at most drugstores in the area you would find ben gay ointment or etc.)  On the second or third day of intense itching I decided to apply the Arnicare.  One application took care of the itch, although it could have been a coincidence that the bruise had passed the itching stage.  I continued using the Arnicare for several days.

The brusing actually got worse and covered the entire area above my elbow crease.

• Showers versus baths.  I thought perhaps a bath would be better for me because it would soak my arm which might be helpful for the swelling.  I was very concerned that I might not have been able to get out of the bathtub though so I showered instead of bathed.  If you have more than one sling (like I did by the second week) you can shower while wearing one.  I didn't find it any easier to use the sling in the shower though because I was very protective of my arm and it never left my side.  You will need some type of bath brush to get your back and the outside of your good arm.  I was not able to wash the outside of my good arm for a few weeks until I was able to hold the back brush near the head so it wasn't so heavy in my affected arm and I was able to get most of my good arm washed.  It never really got dirty though, and shampoo was always rinsing down my arm so it got a soapy water wash ever time anyway.

EATING:  You will not be able to do much cooking.  If you are fine with frozen dinners and fast food you are probaby good.  If someone in your family is the cook you are all set.  If you are the primary cook such as in my case, here are some options:

• Breakfast- consider left overs, cereal, toast, or my favorite-cooked egg whites with mozzeralla cheese.  I found I could crack an egg by smacking it on the bottom of  a bowl, open the egg with one hand, then scoop the egg yolk out with half of the shell.  I was able to cook the egg by myself, plus make toast and tea for breakfast.  
• Lunch-Left overs or Sandwiches (grilled cheese, tuna, left over sloppy joes, chicken salad sandwiches using chicken salad made by my family), soup, or salad using vegetables that were already in my fridge that my family had cut up for me. 
• Dinner-The same as for lunches plus my husband grilled a few times, made the occasional chili and we also ended up bringing home food from Boston Market several nights, bringing chinese food home once, pizza and etc. We celebrated two birthdays and ate at a restaurant one of those times, while my husband made my daughter's favorite dinner the second time.
•  If you can get your family to cook for you it would be healthier.  

PET CARE:

• Medications-unless your pet takes pills in treats, you will need someone to take over for you.  Our dog takes pills in soft treats, but it is too hard to open prescription bottles so my daughter took over giving medications to the dog and my other daughter took over giving medications to the cat.  You will not be able to open the mouth of your pet to give it a pill.  
• Food and Water-my daughters took over the responsibility of feeding the pets but sometimes the girls weren't home.  I had no problem feeding the cats because their dishes are on the counter but bending over to get the dog dishes was very painful for the first three weeks and I could feel the bones shifting so I learned to squat on the rare occasion that no one was home and I needed to get the dog more food or water.
• Walking the dog-Someone will have to do this for you.  You cannot have a dog pulling on your good arm.  If your feet hit a slippery area you will fall and have no ability to catch yourself.  In my case our dog goes out on a cable attached to the house.  I had to remember to squat to attach her to the cable so I wasn't bending over during the times I was the only one home.  I also had to stand over her with one leg on each side of her body and squeeze my legs together so she wouldn't run outside while I reached out to grab the cable.  She complied.

SAFETY:  

• Try not to use stairs unless you have at least one or preferable two side rails.  
• Do not walk down hills as they may be slippery (which is how I broke my shoulder in the first place)  
• Be careful walking in crowed places especially the first three weeks.  It is very easy for people to bump into you.

HAIR TIPS:

• You will need a wash and wear hair style for at least the first three weeks.  I use to wear a pony tail or a french twist, but my hair was in desperate need of a hair cut and I already had a hair cut scheduled for 2 days after my fracture.  I had it cut short and blunt since it was still hot out and I couldn't get it in a pony tail.  After the third week when my doctor said the x-ray showed a mild amount of new bone bridging the fracture sites, and the pain was gone, I could sit down with my arm resting in my lap, and hold my hairdryer in my affected hand.  I could bend my head down toward the hairdryer and dry much of my hair using my round brush to style as much of my hair as possible in front of a tabletop mirror.  It will be a very long time before I can dry my hair the way I use to.  

This picture was after my haircut.  I won't be able to style it this well for quite some time.  My cheek abrasion from my fall is showing also.

• Hair color: I will need a hair color touch up in the next week or two and I am hoping I can convince one of my daughters to do it.  If not, I will have to schedule it to be done at the salon.  
• Ponytails:  For those of you with long hair, I did discover a YouTube video of how to put your hair in a pony tail using just one hand.  You need to gather the hair in one hand (having the hair tie already around that hand), and then shove the hair against the wall behind you while you put the hair band on it.  If I were you I would search for the video.

DRIVING:

• My doctor said I could drive short distances if I was comfortable doing so.  I was worried that if a bad driver hit my car, the police would automatically think it was my fault since I was driving one handed.  My daughter worked very close to home and my husband wasn't always able to drive her.  My other daughter went to the local community college which was close and also had a job that was close, so once in a while I would let them drive me there since they both had drivers permits, then I would drive home.  Because the daughter's schedules sometimes conflicted, it was a necessary evil.  I eventually ran a few small errands  a few days a week after the third week within a 3 mile radius of home.  I felt better by then.  Most of my errands could be run when my daughters needed to run errands.  I would have them drive.  They needed me in the car since they didn't have a drivers license so I would have them take me where I needed to run an errand.

SHOPPING:

• It is easier to pull a shopping cart, then to push one.

FINAL TIP:  You will have to relax your standards of household cleanliness.  Very few people will keep your house the way you like it.  As long as it isn't filthy, you will survive and you will eventually be able to take care of it yourself.  You will obviously need friends and family to help you with routine cleaning, but don't expect them to mop, vacuum, tidy up, do your laundry, cook and wash your dishes on your timeline.  You may need to come up with a list of what you need everyone to do for you so that things are not left up in the air.  If you don't tell someone you can't go downstairs and do the laundry (even if they live with you and should know this), they aren't going to volunteer to do it for you.