Clavicle Chronicles

I am going to treat this post as an ongoing update rather than add new posts.  For most recent part of this post, click here.  You can catch me on IMTalk on Monday August 11, 2014 as I talk about my accident and my recovery on the way to Kona.

Feel free to send any questions to sue@fewoman.com.  Oh and if you want to see some cool GRAPHIC (as in open wound) surgical photos and x-rays please click here.  

I crashed at Ironman Muncie 70.3 on Saturday.  I was having a great race.  I swam hard and was approximately 1.5 minutes off the race leader.  I stayed aggressive on the bike and pushed the whole ride.  Towards mile 35, there was an aid station on my left.  I had already finished two bottles of nutrition and was on my third bottle.

Illogically, I thought I should dump my empty bottle.  I rode closer to the middle of the road, grabbed the bottle and was going to pitch it between the riders on the other side of the road.  Obviously, I am an idiot.  I am even more embarrassed to write that I was going 22.6 MPH when I decided to make this move.

As soon as I started the pitch with my right hand, I felt the front of the bike wobble with my left hand and then the wheel turned to a 90 degree angle and down I went.  I never lost consciousness although I did lay there for a few minutes doing a physical inventory.

Fortunately, I was right in front of an ambulance and received medical attention quickly. I did want to get back on my bike but realized the crunchiness in my shoulder was not normal.  Off to the hospital I went.

I have been thinking a lot about why this accident happened.  I think I started to develop a cloak of invincibility the last seven years.  I am a very durable athlete and overtime I started to feel very confident about my cycling.  I crossed the line to cocky.  Crossing that line is where most accidents happen.

I have also been racing harder and harder to get to the front.  I don’t regret the effort winning takes but it does increase my risks.  Despite the wreck, I think those risks are acceptable as I have learned far more about myself on this path than if I had chosen the less risky path.

On Monday, I was very fortunate to see orthopedic surgeon Dr. Timothy Steiner at 8am. KT brilliantly suggested I not eat anything that morning in case he could do the surgery that day.  We discussed my athletic resume and plans to race Kona in October.  He was immediately on board and scheduled surgery that day.  He said I could be back on the bike (trainer) in two days but only if I dumped all the pain medicine after the surgery. Deal!

I now take one gram of acetaminophen every six hours.  It is amazing how helpful it is for my broken ribs and incision pain.

After surgery, I have not worn a sling and can use my left arm like my right arm (but without lifting anything heavy).  I am doing mobility exercises and my breathing exercises for my lungs and cracked ribs.  It is really wonderful to type this with two hands.

Things I have learned:

  • Always have a will and other medical documents in place to protect you and your family.  Talk to your attorney.
  • Have a spouse that will drop everything to be there in a moments notice and make all decisions when things get fuzzy.  I would not be where I am today without KT!
  • Be clear with the MD’s about what kind of athlete you are or plan on being.
  • Let the surgeon and anesthesiologists know that you are a different kind of patient.  As an endurance athlete I have a low white blood cell count, low blood pressure, low resting heart rate and can be at increased risk for DVT (Deep Vein Thrombosis).  Both physicians listened and put contraction sleeves on my calves for surgery.
  • Be aggressive about your recovery plan.  Dr. Steiner knew the ultimate goal and bought in immediately with permission to get on my bike and start spinning in a few short days.
  • Movement is everything.  I learned from my sisters’ car accident and cancer treatment that walking is very important to recovery.  I have been walking three times a day for an hour total.  My little Yorkie hates me and now hides when I grab the leash. Does anyone need a sled dog for the Iditarod?
  • Stay optimistic.  I don’t do this sport for a living but fortunately my friends who do reminded me that this is common crash and usually involves a quick recovery.  I believe them.
  • Eat even healthier than when you train.  I have reduced my food intake but am focused on eating very high quality foods.  Protein four times per day and lots of water.
  • My worst time is bed time.  I am really tired, hurting and not looking forward to sleeping on my back.  There has been some tears but no cracking.  Fortunately, I am sleeping well and wake up in the morning ready to go.
  • Ice is great for reducing pain.  I apply to ribs and clavicle 2-3 times per day.
  • Consider sleeping with a wedge under your mattress.  Helpful to ribs and clavicle.

Thanks to everyone for their concern and support.  Many of you have been great role models through the years on recovery from physically challenging events.  I can’t thank you enough for sharing your knowledge.

+++

First post-surgical appointment.  Love when your surgeon starts with asking you to tell him what we need to do to get you to Kona.  And then adds, I expect you to win.  Oh and now he is officially an FeWoman sponsor.  Hell, at the rate we are going I may tattoo his signature across my clavicle incision.

Bottom line:

  • Back in pool on the 28th for kicking only and right arm drills only.
  • Can start swimming slowly on August 4th.  Full return by August 11.
  • Bike workouts on trainer can start immediately.  Can hold body up with both arms and go aero.
  • Running can start tomorrow.  Two miles easy, rest day, again and build slowly.
  • Rehab with rotational band movements 2-3 times per day 2 x 15.  Back to PT on Friday.  Already advanced out of first band.
  • Bicep and tricep light curls OK with left arm.
  • Will be using neuromuscular e-stim to maintain muscle mass starting Friday.

+++

Katie’s Notes:

Surgeon started with:

YOU HAVE TO GO SLOW!!!!

Looks perfect, you are ahead of schedule.

Exercise

1) Bike – Only on trainer for bike.  You can go aero and have weight on the bars.  Can not ride on road until you see him again in a month.

2) Running – At first he said not for another two weeks.  Then he said you can start running now slowly.  A couple miles and then a day off.  You need to pay attention to how you feel because of the movement he wants to be careful.

3) Swimming – Can get in pool/hot tub two weeks from date of surgery.   At that time you can kick board and do one arm strokes.  At first he said 3-4 weeks for swimming and then he said if you started slow maybe you can start swimming one week after being in the water.  Repetitive movement can cause the bone/plate to fatigue if you keep doing motion to early before the bone heals.

You can sleep on your side.  You can drive.  Start doing rotational exercises with good and bad arm.

+++
Today is two weeks from my accident.  I am learning that recovery often happens in millimeters and then suddenly is punctuated by a centimeter leap.  I have finally adjusted to the idea that I won’t wake up one morning fully recovered.

But, and this is a big deal for me, I can finally sleep on my injured side!

I am amazed at the focused time it takes to recover.  I have exchanged all my hours typically spent training into recovery.  Here is my schedule yesterday:

    • 4:30am Take Tylenol in anticipation of morning activity.
    • 7:00am Ride bike finally holding my body up with both arms!
    • 7:30am Rehab exercises
    • 7:40am Walk (and of course drag Yorkie for old times sake)
    • 8:00am Breakfast, shower, work
    • 11:00am Take Tylenol and pretend they have not become M& M’s
    • 11:20am Dentist to have damaged tooth repaired.  Decided against having grill installed.  Toyed with installing GPS tracking device.
    • 12:15pm Back to work.  Staff looks at me and asks, “Do you work here too?”
    • 2:10pm PT to learn e-stim.  Discovered electrical pulsing can go from wow that feels good to owwwwww!!!!!!  Plus there are so many muscles in the shoulder it will take hours a day to keep them all from atrophying.  Not that I had many muscles in the first place.
    • 3:10pm Gym for strength training.  Training partner suggests I watch the movie My Left Foot again to get used to my new state.  Bastard. Little does he know the first time I shaved my legs post accident in the shower, I had to keep picking up the dropped razor with my foot.  My right foot.
    • 3:40pm Walk again.  Without dog.
    • 4:00pm Head home
    • 4:15pm Rehab exercises
    • 4:30pm Ride bike and finish second episode of Master’s of Sex. Motivating.  Researching sex seems like a much better hobby than triathlon.
    • 5:00pm Take dog for another drag.  She tried to lock up her 5lbs into a protest walk.
    • 5:20pm Take Tylenol and wonder why I haven’t purchased stock in the company yet.
    • 5:25pm Rehab Exercises
    • 5:35pm Dinner of salmon and kale.  Not f*&%ing around.
    • 6:00pm E-Stim.  The lats almost brought me to my knees.  The good news is that my ribs are broken in back.  The bad news is that the pieces are under my lats.
    • 7:00pm Lay on couch icing lats and incision.
    • 7:30pm Watch Tina Fey receive the Samuel Clement’s Humor Award. This video had me laughing so hard I had to hold my ribs.


Annuale Commercial by bungie_bungie


 +++
Update as of 8/2/2014:

For those of you counting at home I am now on my second bottle of Tylenol.  Before you suggest a support group, please know I am forgetting doses at times.

It is three weeks post-accident and almost three weeks post-surgery.  If you met me on the street, with my shirt on and covering my chest (one would hope that was always the case), you could not tell that I had been injured in a bike wreck. I might ask you hug me lightly but that is my only tell at this point.

I had no idea how much of my personal currency involves hugging.  This must be a midwest thing because I remember not hugging during my East Coast days.

Huge developments this week as my ribs went from screaming “ARE YOU F*&$ING KIDDING ME” with any exercise movement to barely noticeable butter knife jabs with deep breathes.  I am now regularly running, cycling and kicking in the pool.

I am still spending amazing amounts of my day on PT and nightly e-stim session.  I am still walking at least an hour a day and I believe staying active has hastened my recovery.

Unfortunately, I started to quietly ask my friends serving under the “Tyranny of the Fitbit” how many steps we had walked.  Yes, you guessed it, I succumbed and purchased my own dictator.  I think it will be interesting to see walking and it’s impact on IM training.  As well as the reverse.   Plus I can’t wait to see the step count I generate in a 17 mile run.

At PT yesterday I was given a B+ on my current rehab state and was told by the physical therapist that I would be released when I received an A.  I was very happy about my overall progress.  My flexibility in my surgically repaired shoulder is almost equal to the flexibility in my other shoulder.  If you have seen me swim, this is not good.  I found out in PT yesterday that both shoulders need focused work on flexibility.

The hardest thing for me to overcome right now is that the clavicle area of my chest feels different. There is some slightly numbness below the incision that should improve over time.  Tendons and muscles are moving differently around the clavicle and it feels funny. Plus I know in my OCD brain that there is something in there that doesn’t belong.  And to top it off, I am supposed to massage the incision to break up the scar tissue.  Gross. Image of post-surgical incision here (warning other graphic images of surgery too).

I am fortunate in that my team physician David Fletcher, advised me that my feelings about my inner cylon are normal.  I need to see my inner cylon not as an invader but as a new member of my family. Yes, as cliche as it sounds, I am going to work on loving my all of me including my surgically enhanced clavicle.

Operation Kona is on!  My thanks to everyone for their love, support, tweets, FB posts and emails on this journey.  It takes a village to stay positive and focused.  Thanks for being such and important part of my village.  With love.

+++

Questions received:

Why all the Tylenol instead of an anti-inflammatory?

There is some evidence that NSAID’s may impair bone healing and should be avoided. I generally avoid them during my training unless I have an acute injury. You can read more why from our Endurance Corner team MD Larry Creswell Article: http://www.endurancecorner.com/Larry_Creswell/NSAIDs

What is the bar made of  that holds your clavicle together?

Titanium.  I am now a Cylon.

When does the bar get removed?

Never.  Unless I have a problem with it.  I am planning on no problems!

Don’t they tape your ribs to limit pain?

Not anymore as it increases your risk of pneumonia.  It only hurts when I breathe.

 

No Replies to "Clavicle Chronicles"