Lost Bones Reunited! (Hopefully)

Ten weeks after my bike crash in February 2009, I wrote with optimism that my left clavicle fracture was beginning to heal.  And for the most part, the pain subsided over time.  Later in 2009, I was able to complete the 206-mile cycling race, Lotoja, and also Ironman Arizona; although, there were lingering issues with my back strength and upper arm strength, especially on my left side.  Also, I still experienced a sort of searing pain, like the pain a tearing muscle might inflict, in my upper left arm with certain reaching movements.  The pain became worse after I fractured my right clavicle in May 2010 and had to rely on my left arm while that healed.  From the medical imaging, it became clear that the left clavicle fracture had never healed; and after months of PT and ruling out shoulder joint problems (cortisone injection, MR arthrogram, etc.), the orthopedic surgeon determined that the most likely cause of my continued searing upper arm pain was this "non-union" fracture.  Surgery was scheduled for October 24, 2011, approaching 3 years after the original injury.

The surgical plan was to scrape off the substantial hypertrophic (i.e., overgrown) bone growth at the bone edges and to use that material as a sort of grout between the fractured bone ends.  The bone would be properly realigned and then secured with a plate and several screws.  Aside from some pretty unpleasant complications from the general anesthesia and pain meds, the surgery and immediate recovery went smoothly.  The surgeon was unable to remove all of the hypertrophic growth from underneath the clavicle because of the proximity to major blood vessels; but otherwise, things went as planned.  Currently, there is some skin tenderness on the surface of the plate, and it is still too soon to know whether the pain is resolved.  But so far I feel hopeful that it will be better than before.  If the plate bugs me, there is an option to have it removed once the bone has completely healed.

Six weeks post injury; hypertrophy of bone has not occurred yet. (Xray March 16, 2009)

About six weeks post surgery. There is one longer screw to insert into the hypertrophic bone that couldn't be removed.  A healed fracture from 2009 is visible in the 3rd rib down, (Xray 12/6/2011)

What I didn't anticipate about this is that, although planned, the surgery was essentially the same as re-fracturing the clavicle and required a recovery period just as long.  So, I am yet again facing another period of regaining fitness lost to injury.  Of course, I am grateful that I was able to have the repair and the pain was substantially less (not even comparable, really) to the original injury.

6 Weeks Post

6 weeks post accident
Originally uploaded by annetics

Here's a snapshot of the Xray I had done today on my clavicle. It has actually been hurting more in the past week, but the orthopedic PA says that it is still in a good position, and that it is beginning to heal. I'm very grateful that I did not require surgery and will try to be patient. I have a lot of pain in my arm and shoulder area and I guess that may subside once the fracture heals? The physical therapist was pleased with the range of motion of my shoulder joint and got me started on some simple exercises to build my core strength up again. The pain in my back doesn't seem to be improving much these days but I guess that is not too surprising. In my mind, 6 weeks was the magic point when I thought I would feel better, and 8 weeks the absolute latest that I would still be healing. In the meantime, I am glad that I'm able to ride my bike trainer, as mind-numbing as it is, and was very excited to get up to a full hour on Saturday. I'll continue with the mini-updates on the right-hand side of my blog using Twitter. These are mostly so I can keep track of my progress and for my family members who enjoy these details. But, follow along if you're interested.

Morning Thoughts

Morning Rainbow
Originally uploaded by annetics

We've had some pretty intense rain and hail in the past day or two, so I was happy to be greeted by this sight this morning and am reminded how fortunate I am to live in such a beautiful place.

This week is Diabetes Training Camp for the Triabetes captains down in Tucson, and I am not able to be there because of my bike accident on Feb 1. It has been heartbreaking for me to miss it but it just wasn't an option. The healing is going well, and I have been able to get on my trainer for 15 minutes at a time for several days now; but I won't be able to swim, bike (outside) or run at all until the end of the month, at the earliest. I'm really glad I can use the trainer, though, and conveniently, I already had an old tire on my rear wheel, so won't care if it is completely worn down by the trainer flywheel.

I had a visit with the physical therapist on Monday, and she felt that my shoulder joint is in good shape and gave me a few exercises for loosening up the muscles in my arm and shoulder. We couldn't do much with the core muscles because the ribs are not healed yet, so that will have to wait. I have been concerned about some loss of muscle mass in the left calf, which I noticed 5 days after the crash. None of the doctors I have seen felt like it was a neurological issue; the PT felt like it was most likely related to some deep bruising in the area. I still have an area of bruising on the outside of my calf which is quite painful to the touch. Perhaps the bruises in the lower leg just take longer to heal. I am breathing easier since the rib pain is much reduced and I do not get out of breath as easily. I never did get the Xray of my hand because, even if it were broken, nothing would be done about it, and I think I'm getting enough radiation as it is. I still wonder if I broke some ribs on the right side. The last time I saw the orthopedic PA, he said that I had likely broken at least half of the ribs going down the back on the left. He was pointing out the fractures in each rib in the Xray going down the left side. "Here it is, here it is, here it is...."

Despite all of this, the PT and others feel optimistic that I will have a full recovery and I am feeling much, much better than a month ago! It is going to take a lot of work and I think my biggest challenge will be in having the patience to build up slowly instead of thinking I can just jump in where I left off before the accident. In a way, I feel like I have been building a house over the past few years (of training) which was just burned to the ground in a fire. But if I think about it, I probably still have a good foundation and framework, and just need to put the walls back up (and probably not even all the walls).