Week 6 Post Surgery Check In

Yesterday I passed 6 weeks since surgery.   I had my check up with Dr Amit 2 days ago, and he determined that all is going as planned at this time...which translates to there is not evidence of union in the xray (see below).  He's happy with my progress in rehab...my range of motion is coming along with little to no pain, but with plenty of soreness and stiffness.  To try to describe how my shoulder feels, it is like I had a shoulder joint replacement---my shoulder feels almost foreign to me--almost robotic.

Dr Amit okayed active rehab and strengthening of the "little boy" arm and shoulder that I have--a good sign in my mind!  My homework to date has consisted of 4 exercises done twice daily...on wednesday we added 3 additional active/strengthening exercises.  On a high note, with mild convincing, Dr Amit said getting out on my road bike is okay---I just need to stay away from jolting movements...I am still deciding if it is worth the risk, but I think I'm ready to test it with a one hour ride tomorrow morning with the group (ride with the "C's" for sure (C = slow riders).

Outside of what I wrote above, my impression of the fracture is that it has not formed a union...I am basing this on the way it feels when I move it.  Today I am actually getting a little bit of a pinch in the site when I do my pully workout.  This is a first, because I have had no pain in the surgery/clavicle area at all...I did take a "hit" on wednesday while diving to keep Sophia from taking a tumble...and I'm hoping that was the cause.  My impression of the xray is that bone is forming, but we just don't have union yet---and with how things felt during my pully workout, maybe I need to take it careful.  I'll keep taking my Calcium/Vitamin D and plenty of dairy!

To sum it up...tons of progress, but where I really need progress is in the union so I can really start pushing the rehab!

What week is it?? Oh...5 Weeks Post Surgery, almost 8 Weeks Post Crash

So the title of this entry...at this point I have no idea where I'm at!  Surgery and the accident are long gone and now I'm shoulder deep in rehab.  And one word....OUCH!  The crash: one event, it happened...surgery: one event, it happened...rehab---appts 3 x a week: 10 out of 10 on the pain scale, exercises 2-3 x a day:  self inflicted pain...it's a psychological roller coaster.  Sometimes it crosses my mind that I should just stop pushing, accept that my shoulder is not what it once was, and move on...all because of the pain, stiffness, soreness...but then I realize that no matter what I do, the pain, stiffness, and soreness will be there.  I wake up every morning with those 3 words affecting my shoulder (it feels like what I imagine a 90 year old feels like getting out of bed, but for them it's every joint).   The first thought in my mind is, geeze, if I had a race today, this shoulder makes me doubt if I would enjoy the challenge of racing when my body is not an "army of one."

Then there's the good news:  most of the soreness happens because now I can use my right arm!  I can finally shake hands without concern, lift Sophia up with both arms (versus the one handed swop technique), let Sophia lay next to my right arm...it's come a long way!  My range of motion seems to get better literally day by day---the stiffness and soreness is always there, but that's due to the constant workout my right arm is getting versus the 5+ weeks it spent motionless in the sling.  I've been on the bike trainer a fair amount, and I can comfortably place both hands on the bar...I have a follow up appt this week with Dr Amit, so hopefully I'll be back on the road next weekend---I'm even tempted to try it out this weekend, but I told myself to not rush this thing and to listen to the pros.   AS a side note, I've been taking Calcium/ Vitamin D complex from Solgar for a week now (before I was taking Kirkland Brand...just decided to switch on a recent trip to Whole Foods)...it's impossible to say I have noticed a difference, but the combo is ideal for bone formation, so I've been told.

Final notes on this week:  it feels like, for the most part, that the clavicle union has occurred, even though some times (especially after intense PT sessions), that the bone is still in two pieces...we will just have to wait until this weeks appt.  The muscles and tendons are definitely feeling like they are loosening up, and Brandon and Nate are telling me it is progressing well...I can see the light at the end of the tunnel, but the end of the tunnel is only the beginning---I'm not giving in for anything but full range of motion, or at least giving it my all to get as close as possible.  

TGIF?? Not on the IM Prep Yet...

So today marks the end of the first week of Physical Therapy (and 4 weeks post surgery)...now I understand why people have told me that this is a tough injury.  I visit Brandon and Nate 3x a week over at Endurance Rehab---which should really be called "How to put someone in a UFC submission hold."  The good news is they are buddies as well as my therapists, the bad news is they are buddies as well as my therapists ;)  They know I am committed to getting full range of motion back, which means they're gonna push the pain!   I have a hard time understanding the rationale of treatment, because it seems like the fracture has not healed, and the exercises don't exactly promote stability of the fracture, so I guess the movement of my shoulder will promote the pieces to at some point callous together?  Literally, during manipulation, I think they are trying to "grind in" the two pieces--it feels as horrible as it sounds. Additionally, therapy consists of them basically breaking up the scar tissue that has developed---which feels like they are tearing the tendons and ligaments to allow me to move it again.  If I don't do my part at home (3 exercises 2x daily), the shoulder will tighten back up...putting yourself through the pain electively, I have to say, is harder than having someone else do it, because at least you don't have a choice when they do it.

So life goes on...Nate also let me know that realistically I shouldn't expect to get back on the bike or swim until July 15 (which is 3 months from the day of surgery---standard protocol...2 months from tomorrow...ouch!  So, I'm working my tail off with the exercises, riding the trainer as much as possible, and playing with Sophia and Jenny as much as possible---life is good!

The Final "Crash Aftermath" Post!

It's time for me to move on...nope, I'm not discontinuing this diary, but going to the next chapter!  Yesterday was my first Rehab session---so I'm healed ;)))  Only kidding, I have a long road ahead of me before I'm swimming laps (and even longer before I'm swimming 5K again like I was 6 weeks ago), riding on the road (...100+ miles on saturdays), and running (...2 hours at race pace).  BUT, i did ride the trainer 2 nights in a row, and I could actually place my right hand on the handlebar last night!!! (for a whole 60 seconds at a time!)  Baby steps!

So Rehab Appt #1 was last night with Brandon---right away I was amazed at what he was able to do with my arm that hadn't left my side since March 29.  He immediately had the arm off my side while I was laying on my back on the table...working it to almost straight out from my side laterally and frontally--I was the happiest person in the world watching in pain ("tell me when it's a 6 on the pain curve").  After he loosened it up a bit, we started exercises (just 3 of them for now) for me to do 2 times a day, everyday along with pendulum exercises as well.  After, the shoulder was dead, but I was happy, and off to home I was with my bag o' ice.  The cousins were all spending the night, so pizza was the dinner menu---3 pieces later I was stuffed beyond necessity.  The pizza would not digest, but I wasn't going to go without my trainer session, so I jumped on the bike, started the 2009 Ironman DVD for the 100th time, and rode with that right hand finally making it's way back to the handelbar!  I am thinking my goal of June 1st is within reach for training full speed ahead---but this is just the first step of many to come before I get there...I should keep that in check!

My goal for now is riding the trainer at least an hour a day until I get back on the road...then, full speed ahead!

5 Weeks Post Crash...3 weeks post surgery...

I would say life is returning to normal...if normal was everything I did pre-accident minus all the training (aka couch potato Svans!).  Today was my first day out of the sling for the entire day, and I'm glad I toughed it out.  It's a lot like being sick and staying in bed for a day or two--you dread leaving the house, but once you do, you're glad you made it "over the hump"...so in essence, today was an "over the hump" day!  Yesterday we traveled back from our 5 day stent visiting my family in the SF bay area (thanks again Mom, you don't know how nice it is to be able to stay with you and just relax while we get to hang versus all the busy-ness!)...traveling with one good arm and a two year old is tough, but Jenny, like always, picked up more than the slack my shoulder has created and made the trip very enjoyable and relaxing---thanks babe!!!

So an update on the shoulder since my last post:  the post op appointment with Dr Amit went as expected...things look good, but we need to wait on the union of the two pieces before I consider any weight bearing exercise (ie holding a handlebar, swimming...).  I am cleared to start rehab (starts in 2 days---pain is temporary!), and I'll be seeing Brandon and Nate at Endurance rehab 3 times a week until I'm back to full strength.  While my shoulder is very stiff, very sore, very weak, but not painful, our biggest concern still is getting union of the bone fragments.  Being the special person that I am, when you have a fracture in the distal third of the clavicle, non-union of the two portions of the fractured clavicle is the number one concern, and can potentially require further surgery if pain and a lack of range of motion persist---in my case, Dr Amit stated that removing the distal 10% of the clavicle would be the treatment regimen if this were to occur...THIS DOES NOT SOUND GOOD!  So say your prayers for me (as one of my favorite patients is already doing for me in her prayer vigil tomorrow ;.

In the x-ray below, you can see the anchor in the coracoid---it is attached to the clavicle via a fiberwire that runs through the "slot" you see in the clavicle; which stabilizes the position of the medial 90% of the clavicle, but does not stabilize it to the distal 10% of the clavicle.