Things Always Come in Threes

My mother-in-law says, “Things always come in threes.” I don’t believe that but I can’t help notice coincidences in my practice. Usually, it involves looking for different patients with similar illnesses or injuries. In this first case, it was infant twins who shared three identical abnormalities.

Mom brought in her fraternal (not identical) twin daughters for fevers. They had been sick about the same period of time. I diagnosed both with urinary tract infections. It was kind of a surprise that the two of them would come down with an infection like that at the same time. I also noticed they both had umbilical hernias and were tongue-tied. Umbilical hernias are hernias at the belly button. They are not at all unusual in kids this age but it was certainly an interesting coincidence that they both had them. To be tongue-tied means that the frenulum (the small fold of skin beneath the tongue) is too short or tight. This keeps a person from being able to stick his or her tongue out normally. It is usually treated with a minor procedure where the doctor numbs and snips the frenulum, releasing the tongue to stick out normally.

It seemed to me quite a coincidence that both of these sisters had the same three abnormalities.

Speaking of coincidences…

One night, a young man was dancing. While doing so, he thrust his arm into the air, causing a dislocation of his shoulder with the arm stuck straight up in the air. Shoulder dislocation is a pretty common injury we see in the emergency department. That it happened when he was dancing was really unusual as the shoulder usually dislocates because of a fall or other injury that involves more energy. Also, a shoulder dislocation usually results in the patient’s arm hanging down at his or her side. Having it dislocate so it is locked with the arm pointing straight up in the air is also very unusual. I gave him pain medicine and sedatives. I was then able to easily get his arm back in the socket again.

Two nights later, another young man came in with his shoulder dislocated and stuck up over his head. Rather than dancing, this happened when he rolled over in his sleep. It sounds crazy but there are people whose shoulders can just pop out of joint, even from rolling over in bed. Usually this joint instability arises from previous dislocations which damage the supporting structures of the joint leaving it subject to easily popping out. This often needs to be corrected with surgery. Again, they usually present with the patient’s arm down to his or her side. That he also had his shoulder locked with his arm pointing up only two nights after the other guy is quite a coincidence.

You can imagine my mother-in-law would have had me keeping my eyes out for that third shoulder dislocation with the arm pointing up in the air, but it never happened.