My Post-Clavicle Surgery Update

By John Marsh, Editor & Publisher

 

First off, thanks for all of your wishes for good luck and a speedy recovery after my column on April 21 announcing that I’d be having clavical fracture surgery on Wednesday, the 27th.

Turns out, I needed the luck, as the clavicle was smashed up a good bit more than first realized. Instead of 2 neat but displaced pieces that would simply be aligned and fastened back together with a metal plate and screws, the bone was in 5 pieces (one of which was so small it was excised), and required 8 screws to refashion. (See the “new me” x-ray.) The 2pieces of bone in the middle are screwed into the main bone pieces with 2 screws, and then 3 screws on each side fasten the approximately 5-inch-long plate (13cm) to the big bone sections.

Because of the seriousness of the fracture, I’ll also likely have stimulation therapy to help promote bone growth (though I am at the mercy of my insurance company and am awaiting a decision). Despite the more complex fracturing, the recovery time has not changed. In a follow-up visit with my surgeon on Tuesday, he reiterated the timetable of “x-rays and out of sling” in 4 more weeks, with a road-ready date another week or two beyond that. So, a total post-surgery back-on-the-road time of roughly 6-7 weeks.

My quite long incision has healed perfectly thus far, meaning I can A) shower again and B) get on the trainer in another day or too, hopefully. Small blessings, both!

My surgeon stessed that the bone would not be completely healed in the next 4- to 6-week block, but that the process would be far enough along, with enough stability, for a return to the road.

Quick Personal Reflections

I don’t want to dwell on any of this, but I do want to share my experiences – and what I’ve heard from RBR readers and contributors who’ve gone through similar issues – in order to provide something that might be useful to anyone who suffers a similar injury.

I’ve been keeping mental notes, and today reviewed my own Fly6 taillight camera video of the crash for the first time – confirming what caused my tires to lose contact, and also confirming what a great job my buddies Bill and Kirk did managing the situation and keeping me on point in doing what was best for me. I’ll write a follow-up piece on that soon, but I do quickly want to recap my post-crash recovery highlights to date.

Serious Business – Take it Seriously

I have to admit that I had been lulled into complacency by how well I handled the post-crash period leading up to surgery, not even needing the sling after the first 4 days. The pain was not bad after a few days, and I had surprisingly good range of motion in the arm and shoulder, though the twisted and bruised chest wall really made breathing (and the occasional cough) very painful at times. But all that passed.

By the time surgery rolled around 10 days post-crash, much of the road rash had been brought under control (though I still have one spot on my forearm that is still not quite there). Also still lingering is what remains of a giant yellow bruise the size of a canteloupe that I called the “yellow rose of Georgia.” (It’s now got some new, darker coloring in spots, from the surgery.)

So, because I was feeling pretty good, I really was anxious to get the surgery done and get the real recovery underway. The surgery itself went fine. It was in the morning last Wednesday, and I was back home in the care of my wife by 1 p.m. – a total in-and-out time of about 6 hours. Still under the affects of the general anesthesia and the nerve block that 100% deadened my left shoulder and arm starting from the neck down, I felt pretty OK that afternoon. But my neck felt like it had been tied in knots, and the pain in my shoulder and upper arm started to build that evening. By the time I went to bed that night, I was absolutely miserable from the pain and utter discomfort – and that’s how I stayed the entire night. I doubt I slept even a minute. It was surely one of the worst nights of my life.

Be Prepared – Really Know What to Expect

Part of the problem was some faulty advice from a nurse on how best to dole out the Percocet I was given. But part of it, upon reflection, was just not having a really accurate idea of what to expect. You hear “the first two days are the worst,” but no one tells you what that might mean for you, or your caregiver. And after handling the post-crash period so well, I thought I was prepared for a little pain and discomfort.

Well, what “the first two days are the worst” meant for me was was feeling like my neck had been backed over by a truck (it’s still bothering me, in part the doc says, because they had to cut some muscle around that area to get to the bone), and having waves of flop sweat, alternating with waves of chills – surely side effects of the general anesthesia and/or the combination of meds I was taking. Those included an anti-nausea med (which came in quite handy), and a stool softener. Turns out that opioid painkillers are notorious causers of constipation.

Oh yeah, when your arm is in the sling 100% of the time over those first few days, even in bed (while sleeping on your back; another source of discomfort for me, a side sleeper), and you naturally suffer some wound-area swelling, that swelling just works its way down your arm all the way through your fingers. So, the icing of the shoulder area they suggested 3 or 4 times a day turned into marathon icing sessions of 20-minute periods on one area (say, shoulder and neck, then following down the arm, first with the upper arm, then the forearm (both sides). Repeat. And repeat again. Days 3 and 4 were my personal return to the Ice Age; I was veritably encased in ice for long stretches of each day. (Anti-inflammatories are verboten, as they slow bone growth.)

My arm is still swollen to the point of discomfort, but at least as of Tuesday, I can remove the sling for a while and stretch it out before re-slinging for the long haul.

I had planned from the beginning to take off Wednesday through Friday, with thoughts of sitting around with the iPad and knocking out some personal stuff, maybe even getting a bit of work done. Well, none of that happened, really, and I was quite thankful I had not planned on being back at work till Monday. Even then, I still wasn’t prepared for a full day – nor was I on Tuesday, and I still wasn’t supposed to be driving yet – so again I was glad I had worked ahead before surgery. So, if you have the ability to take a few days or a full week off around a similar surgery, do it.

Another thing they tell you about a surgical recovery is: It gets better day by day. And that is absolutely correct. Not that you don’t have new and different issues to take care of along the way. But, overall, you start to feel better, and sleep better, each day. You regain energy, start to wean off the pain meds, and can do more things for yourself. (One last mention of things they don’t tell you: You’re nigh totally dependent on someone else to help you with everything when you lose the use of an entire arm, from dressing to cutting your food to helping sponge bathe you to buckling your seatbelt. It can become quite frustrating both for you and your caregiver. You both would be well-served to know just how that relationship will work going in!

The Progress Starts to Steamroll

One great human trait is the ability to forget. Without it, we’d all be damned by our pasts and fearful of ever repeating those things that brought us much pain and suffering. But the ability to forget that stuff over time lets us keeping pushing forward, into a hopeful future.

So as each day gets a little bit better, the progression starts to steamroll. Now, 6 days on, I can button my shirt up, shower, drive (picking up my bike at the LBS tomorrow! – the trainer beckons), and start my recovery training plan that Coach John Hughes is working out for me to prepare for the Tour of Wyoming in mid-July (see his column that follows this story).

Each day now is starting to get increasingly better, as I get farther away from those first two nasty days and closer to what I know will be the utter bliss of my first ride on the road in 2 months after my crash. And with a great goal out there to boost my motivation for training through myrecovery, I’m feeling even better.