Good to go (also, cool x-rays!)

Well, that was reassuring.  Worse than predicted by the physio, when I went for my 8 week check at the hospital, yes they took an x-ray; but not only did they not do much assessment of mobility/range of movement, they did none at all!  The consultant asked "how's is it?" and then moved on to "you need to leave the plate in for another 6-12 months before considering taking it out if you want it out".  And that was it!

I'm allowed to do absolutely anything and there's no need to go back again.

So here are the x-ray progress pics...

10 days after the crash, with no intervention:-

 
Immediately post-operative (click to enlarge and note the headphone in the front-facing [top] one and the springs and wires in the angled [bottom] one, probably from a surgical implement to hold stuff in place; also note the two screws not going through the plate, which hold chunks of bone together):-

And here we are, 8 weeks post surgery.  Healing up nicely:-

So there we are.  Off to physio this afternoon to get cracking with putting some muscle back in place again.

Recovery update

Yesterday, I had the first hospital check-up and physio appointments since I have my surgery.  The hospital check-up involved an x-ray to see how things were going with the plating and alignment of all of the fragments (shame I didn't get hold of any images, I really must ask at the next appointment 'cause they look really cool!).  A quick trip to radiology for that and then back to the consultant for a chat.  The consultant of the day, Mr Sharif, looked at Mr Pearse's notes from the surgery and laughed at the capitals and underlined; "ABSOLUTELY NO resistance, lifting or weight bearing till week 8 and only after a full range of movement has been obtained."  I don't think anyone expected the improvements I already have on that front, but anyway... next was having the dressing taken off, the butterfly stitches removed and the ends of the dissolvable stitches trimmed so they don't irritate me any more.  I'd been getting quite itchy from those.

The nurse peeled off the dressing and unstuck the butterfly stitches.  It felt pretty weird, to be honest.  I have absolutely no sensation at the end of my shoulder; the nerve serving that area was severed during surgery.  I was warned that it was about 80% likely that I may at least temporarily, if not permanently, lose sensation somewhere around that area, so that wasn't a complete surprise (you can see in the diagram below how many major nerves there are around the clavicle and where the incision would have been made - I am not a doctor, but I can imagine there are a bajillion minor ones around there and it'd be almost impossible not to end up cutting .  What was a surprise is where the sensation loss is and the effect on the surrounding area.

Credit:- MEDICAL RF.COM/SCIENCE PHOTO LIBRARY

I was expecting the area just below the clavicle to be numb, but it's the end of my shoulder (where the knobbly bit (or, acromion) sticks out,) and below that for about 4 inches, in a rough circle of 4" diameter, that's affected.  What's annoying is that the skin around it is super-sensitive in some kind of compensation for it and the slightest brush against those bits of skin gives an overload of feedback to the point of feeling painful.  Also, when the dressing and butterfly stitches came off, there was a good amount of top layer of skin lifted off where the road rash was, and those bits were a bit weepy.  No matter, I got a clear dressing to get me home from the appointment and an instruction from the nurse to "give it a good scrubbing" and "use your normal moisturiser on it 2-3 times a day" to minimise the scar from the incision.

Anyway, I asked the consultant what I was and wasn't allowed to do, exercise wise, and came out with an understanding of; running (as long as I don't fall over *cough*) is allowed, using a spin bike with no hands is allowed, immersing the wound in water is allowed (as long as I don't lie in the bath for hours), I can swim in a couple of weeks (as long as I don't use that arm - so finning out to the Coffees of Hawaii boat at Kona will be OK :o)).  Still "ABSOLUTELY NO resistance blah blah..." for another 6 weeks and a follow-up appointment in 6 weeks to take another x-ray and assess progress.

So, all good there.  Off to the physio next.

Having been utterly religious with my exercises since I was discharged from hospital, I knew I'd done pretty well with recover of mobility so far.  When I saw the physio, he was amazed at the progress.  He said it was incredibly good at this stage, almost unbelievably good.  Check out this more typical progression.  At exactly 2 weeks from surgery, I already have almost 100% mobility across all of the ranges of motion for the joint; I'm just missing 5% or so in the external rotation.  This is both brilliant and awful.  Brilliant in that I'm recovering so quickly, awful in that I still cannot use that arm for any resistance, lifting or weight bearing of any kind (anything up to and including a cup of tea is fine, more is not fine) and with such great mobility it will be all too easy to absent-mindedly do things (to be honest, the mobility reduction was my most frustrating experience.  I have to be mindful and careful and... well, really careful.  The bone bits may well be held together with a titanium plate and screws, but they still need to stick together and heal and loading up the joint will retard, prevent that process or even make the whole situation worse.

All in all, I'm really happy with the status at the moment.  I'm happy to have had 50 minutes on the spin bike today and I've got parkrun tomorrow.  Looking good!

Recovery and rehabilitation

When I was discharged from hospital; 11 days after crashing at Ironman 70.3 Ireland and breaking my collar-bone, having had a titanium plate and 8 screws put in to pull the bits together, make it all straight and help it to heal properly; I was given some exercises to do (by the hospital physio specialising in orthopaedics) and told "NO RESISTANCE OR LIFTING AT ALL for 8 weeks AND when full ROM regained" (by the orthopaedic surgeon).  I felt a bit stiff and hadn't really tried to do anything with that arm since the crash - it was just natural not to even try.  I didn't realise quite how reduced the range of movement (ROM) was until I tried to do a few simple things.

I couldn't lift my arm more than an inch from hanging without assistance.  I couldn't shrug my shoulder at all. I couldn't grip anything with my left hand.  I couldn't move my arm sideways from my body at all.  I didn't even try moving it backwards.  So, getting dressed, putting my hair into a pony-tail, washing large bits of my back and my right arm and shoulder; none of that was possible.  But I'm a really good girl when it comes to doing as I'm told for my own good with these things.  Religiously, every day, 3 times a day, I did my exercises; pendulum swings of the arm in circles, raising my arm straight out in front of me (initially with the assistance of my right hand), crossing my arm in front of my body to touch my right shoulder and back out straight at shoulder height (initially with assistance from my right hand).  And on the 8th day, I could just about put my hair into a wonky pony-tail at the nape of my neck.  On the 9th day, a straight one actually in the middle of the nape of my neck.  Then on the 11th day, I managed a pony-tail at the usual height on my head and rolled deodorant under my right armpit with my left hand!

Honestly, it's the little things... and it's not a lack of lifting power that is the hard thing (I don't think that's dropped much at all, but I have no idea as I'm not allowed to even try) it's the shocking lack of range of movement/general mobility that you really don't expect with this particular injury.  Though it is coming back quickly.  The surgeon seemed to imply that I may have it all back 8 weeks after surgery, I am confident it'll be back before then once I've got cracking with my normal physiotherapist.

Off to trauma and orthopaedics this morning for a check up and hopefully get the stitches out.  I'll ask about hydrotherapy, using a spin bike and whether/when I can start running again and see what they say.  Then it's physio at the end of the day with the protocol from the surgeon, to get started with him on increasing ROM (and after the 8 weeks is up, start on strength as well).