Monday, March 25, 2013

Pliny the Elder

I'm having it.

Sunday, March 24, 2013

Collarbone at 1 Week Post-Op

Friday was my first post-op appointment with Dr. McGovern. I had been looking forward to this appointment for several reasons. I was anxious to see the x-rays of the completed repair, and also to find out how soon I could get back to being active.

The first picture below was taken right after completion of the surgery. You can see the plate, and the 12 screws holding it in place. Near the middle, you can see a screw that is not a part of the plate, and on its own. This one was necessary to hold two of the four bone fragments together before the plate was even applied. Quite a wreck I was, but some beautiful artwork here by Dr. McGovern to put me back together.

A better view of the lone screw

I had several questions for the doc at my appointment, mostly related to how soon I can ride again, and what I can do in the meantime in the way of self physical therapy. He tested my range of motion, and found it very satisfactory for this stage in my recovery. He told me that I could reduce use of the sling when I am around the house but told me to wear it out in public, really as a warning to other people not to come up and hang on my arm or anything like that. He cautioned me on not raising my arm above 90 degrees, or lifting anything heavy. He explained that it will take another 4 weeks for things to really solidify, and until then it is still possible to do "silent damage" to the repair. Not interested in doing that, thanks! After the 4 weeks (6th post-op), he will start clearing me to ride again and do more things as my condition allows. Until then, I'll keep doing my pendulum exercises (leaning over and swinging my arm back and forth) and trying to get used to doing everything with my right hand!

This pic is from the appointment on Friday (1 week 2 days post-op). Looks kinda like a caterpillar with long legs! My next appointment is in two weeks. I'll provide more updates then.

Friday, March 22, 2013

Broken Collarbone

Two weeks ago during my weekly Wednesday night mountain bike group ride, I took a spill. A pretty nasty one as it turned out. A trip to the ER produced the x-ray image below, and a diagnosis of a fractured left clavicle. A complete break, being displaced almost 3cm. The ER doc said that it might need surgery, and referred me to a orthopedic specialist. 

Fortunately, I happen to have a good friend and riding buddy who's wife is a PA at an orthopedic clinic. She set me up for a consult with Dr. Brian McGovern at Torrance Orthopedic. She recommended him as "the guy I'd send my husband to in this situation". Good enough for me! Met with him the following Monday, and I liked him right away. Confident, knowledgeable, and covered all of my concerns.  He explained that depending on the nature of the break, there are two ways to treat such an injury. You either let it heal on its own in a sling, or have it repaired surgically with a titanium plate and screws. He said that the surgical option is becoming more prominent in the specialty lately. The malunion rate of the "self healing" option can be as high as 30%, especially when the displacement is greater than 1.5-2cm (me). The malunion rate among the surgically repaired is closer to 3%. Since the displacement of my break was of the larger variety, Dr. McGovern recommended the surgical option for me. A side benefit of the surgical option is also quicker recovery time. 6-8 weeks, versus 10 weeks or more the other way. It also means a sooner return to fitness activities, so that I might maintain some of the fitness that I had begun to accumulate this season. Not that I am in any way comparable to pro cyclists, but when Thor Hushovd broke his collarbone back in 2010, he was racing again at 6 weeks post op. On cobblestones, no less!

As you can see below, I went the surgical route on Wednesday 3/13. According to Dr. McGovern, it was a bit of a mess in there and not a slam dunk case, but he was very happy with the outcome and expects a solid recovery. The first night post op was pretty rough once the surgical nerve block wore off, made worse by the fact that the pharmacy wouldn't fill my percoset prescription because of some sort of clerical error. All I had was Vicodin, and let me tell you... It wasn't near enough. Once I got the percoset the following morning, things were all good. The pain was very manageable after that, and I was quite comfortable on the couch for the next few days. I slept there too, in a semi-upright configuration for the first few nights. I must say, I am very fortunate to have a lovely wife that took excellent care of me while I was a vegetable.

At 1.5 weeks post op, I'm feeling pretty good. Most of the pain is gone, and I'm off the pain meds. Getting dressed still takes some time and assistance (try putting on socks with one hand!). I've been doing some walking/hiking, and even gave the recumbent bike at the gym a whirl. I have my first post op appointment later today, where I hope to learn more about what I can and can't do in the coming weeks. I've picked up some great info from fellow cyclist Mike McQuaide's blog, and I'm hopeful that I'll be able to get back on the bike soon. I'll update with post op x-rays after my appointment today.