OT Going under the knife

[gone]

As detailed here (http://forums.thepaceline.net/showthread.php?p=162291#post162291) I had a cycling accident late last year. xrays and an MRI I had done last week upon my return from Italy confirm what I already knew: the collar bone didn't heal particularly well so I am going to have to have surgery. There was some hope that it would be relatively minor and could be done arthroscopically, that hope is also gone. 4-5 inch incision, reshape the AC joint, repair the ligaments, screws to reseat the clavicle and more or less completely immobilized in a sling for 4-6 weeks followed by a second surgery to remove some screws. I'm going to have the surgery done next Monday (the 26th) and for more good news, quoting from an orthopedic journal:

"Several studies have been done looking at what happens to the acromioclavicular (AC) joint after this injury. It appears that many people, whether they had the joint repaired surgically or not, will need an operation at some time in the future. The injured joint degenerates faster than normal and over time becomes arthritic and painful. This process may take years to develop, but sometimes this happens within 1-2 years."

So some accidents just keep on giving! At least it will give me something to look forward to as I grow old. Needless to say, I'm a little down about all this.

So other than whining publicly, why am I posting this? Well, it goes like this. I've ridden 10-12k miles per year for more years than I care to admit but since I've gotten back from Italy I've had a tough time making myself go ride. When I have gone, I've enjoyed it but most days I think "what's the point?" and don't go. I'm normally a fairly upbeat person and am sure I'll get over it and my zest for riding will return but I thought I'd offer my tail of woe in the hope that each and every one of you would appreciate and enjoy your next ride that much more (seriously!).

So get out and ride, rest assured that I'll be avidly reading your reports of great rides, equipment reviews, problems, questions, etc., and looking at all the great new bikes on the gallery and, who knows, I may even peck out a reply or two with my one good wing.

Take care, ride safe and enjoy!

[catulle]

I had AC surgery this past February. MP. The problem is that as a result of the bone damage, some muscles go lazy and slack and can't hold the shoulder, which results in pain and more compensation and more pain... PITA and in the shoulder. Physical therapy is slow but absolutely necessary. Make sure you get a good physical therapist; most don't know what they are doing, atmo.

I hope you heal fast. God bless.

[Fixed]

bro I hope you mend up fast.. that is something that could happen to any one who rides , I hope they fix you good as new bro
cheers

[Louis]

Greg,

Best of luck with the surgery and your recovery.

As far as the down time due to this, I suggest that you take the long view. I just checked your personal profile and based on your DOB it looks to me like this will only be a minor hiccup and that you have many more years of enjoyable cycling ahead of you.

Take care.
Louis

[vaxn8r]

... Make sure you get a good physical therapist; most don't know what they are doing, atmo...


I hate to read broad, sweeping statments like this. I'm sure you probably didn't mean it the way you wrote it. I'm sure in PT, like in any field, there are some who are less qualified or less interested. I've actually been overall impressed in the last decade with improvment in PT/MD communication skills and especially with documentation of progress and performance.

I think sometimes people have unrealistic expectations today in regards to their health and recovery after injury or illness. My wife had knee surgery last year. In some ways she's noticed improvements but in others I think her knee will never be quite as strong as it was in it's painful yet "virginal" state. After some injuries/prodedures you just don't heal completely. There's always the exception, thankfully.

ATMO

[Ginger]

ghsmith...good luck with the surgery and I hope everything heals up well this time around
Mary Ann

Injuries and Physical therapists.

The problem with injuring a joint, and bringing it back from surgery and saying: It will never be the same. Is that you had surgery because it wasn't the same any more and never would be. In my case, the surgery "same" has always been better than the post injury "same." So yeah...your joint will never be the same after surgery, but it wasn't the same anymore before surgery either.

Physical therapy:
It isn't that most don't know what they're doing. It's that they have different interests and expertise. Some are more used to dealing with aging patient injuries and reconstructions, some are more sport specific, some are more into aggressive treatment, many aren't. Some physical therapists never have a regular clientel of high level atheltes, or athletes of any sort, so to walk in as a cyclist and expect them to know what to do with you? MMM no. They're going to treat you like the rest of the 70 year old sedentary hip replacements they're dealing with on a daily basis. Shop around.
The other thing is that when a PT is agressive, they loose patients. If you're in business to make money, that isn't a positive thing.
The other thing I've seen people be unhappy with is that they aren't 100% after PT. But Physical Therapists aren't there to get you to 100% recovered. They're only shooting for 80%. The rest is on your own. My experience says it takes up to a year after PT to get to a point that you aren't improving anymore.
Most therapists I've talked to, and explained exactly where I was before the accident, and where I'm going to with my physical therapy, and what I expect of them are more than happy to be more aggressive than they are with their usual sedentary patient.

Oh...I'm not a PT. I'm a patient. Above is just my experience over 5 years of physical therapists.
YMMV
Ginger

[catulle]

I hate to read broad, sweeping statments like this. ATMO

You're correct. That would be sloppy thinking. I feel the same way you do. However, I've had over seven years of problems with my left shoulder and my experience with physical therapists has been awful. Perhaps an aggravating factor is that I am a very disciplined patient, so the therapists find it hard to find blame on someone other than themselves.

But, again, you're right. Unfounded generalizations reflect shoddy thinking. Thank you for pointing it out, atmo.

[JohnS]

+1 on Ginger's post. I found the same thing when I was going to my PT. Worse than the older patients were the Workers Comp injuries. Many were there when I started and still at the same level when I left. After I had a frank talk with my PT, she got a big smile on her face and was more than happy to be more aggressive.

[67-59]

+2 on Ginger's post. And the same holds true for docs. The key is finding one who has the particular experience/expertise that you need. Best wishes on a successful surgery and a full recovery.

[Ginger]

Needless to say, I'm a little down about all this.

... Well, it goes like this. I've ridden 10-12k miles per year for more years than I care to admit but since I've gotten back from Italy I've had a tough time making myself go ride. When I have gone, I've enjoyed it but most days I think "what's the point?" and don't go. I'm normally a fairly upbeat person and am sure I'll get over it and my zest for riding will return but I thought I'd offer my tail of woe in the hope that each and every one of you would appreciate and enjoy your next ride that much more (seriously!).



Greg,
The ramp up to surgery is always like that for me. I want to go ride, and I have a good time when I do...but getting out there is always tough because I know I'm just going to loose any fitness that I build...so I get that same "what's the point" attitude. If it gets too bad talk to your doc about what you can do about the depression because that can get in the way of your healing and physical therapy. Heck, just some extra B vitamins might be enough to perk you up a bit.

And don't pay too much attention to the scientific mags. They have some good points, but they're certainly talking the worse case scenario. Reading those things isn't near as depressing if you think: They only see the returns of the surgeries that didn't work...and mine will work!

Good luck!
Mary Ann

[JasonF]

Sorry to hear about your woes. I spent two years of my life having a total of 7 surguries to repair a shattered leg, multiple facial fractures, broken back, etc, etc...after getting run over by a truck while riding. I also went through the same emotions. I even went as far as giving away all of my bike clothes, tools, stands, accessories, etc...since I was convinced I would never be able physically or mentally to ride again.

Hang in there, from your annual mileage numbers, it's obvious that cycing is a huge part of your life. With time to heal, I'm sure the desire will return. Maybe while you're laid up you can treat yourself to a high zoot set of wheels, or something that will make you yearn to ride as soon as possible.

Good luck with the surgery, please let us know how it turns out.

[PaulE]

the ones to be removed? If so, maybe you don't need to have them taken out. This Saturday will be my 3rd anniversary of a broken collarbone, ribs and shoulder blade. My collarbone was repaired in an operation about 10 days after the accident with a stainless steel plate and 6 screws. The doctor said I could have the plate and screws taken out, but they don't bother me so I'm not going to bother with another operation. And to my surprise, they don't set of the metal detectors at airport security. So the plate and screws are staying.

I was lucky and got a good physical therapist. It was my only experience with PT and I think he did a great job. The muscles lose their range of motion during the immobilization period, so absolutely do the PT.

I didn't ride all summer that year, and was a little hesitant when I first came back. I think that's normal, and you will want to ride again when you can.

Good luck with your operation.

[palincss]

I'm going to have the surgery done next Monday (the 26th) and for more good news, quoting from an orthopedic journal:

"Several studies have been done looking at what happens to the acromioclavicular (AC) joint after this injury. It appears that many people, whether they had the joint repaired surgically or not, will need an operation at some time in the future. The injured joint degenerates faster than normal and over time becomes arthritic and painful. This process may take years to develop, but sometimes this happens within 1-2 years."


"Many" in this case could conceivably be anything from 10-20%, up to 80-90%. The web site I found googling that quote offered nothing more specific than "many". Follow-up googling the arthritic condition they named turned up articles that implied that the condition varies a great deal in severity. So, as I see it what you know at this moment is that you have an unknown chance of developing a condition of unknown severity at some unknown period of time, which might or might not be manageable to an uknown extent by various methods of treatment. In short, "?" .

I'd say it was a bit early to be feeling hopeless about this - there appears to be a lot of room to dodge the bullet.

[JohnS]

Your rehab period might be a good time to try some crosstraining. Do some hiking while you're off the bike. Not only is it good for cardio, but being out in the woods can be therapeutic in its own right.

[gone]

First off, thanks to all for the best wishes and suggestions. As I said, I'm normally a fairly upbeat person and I'll get over it. As JasonF noted, cycling is a big part of my life and it's tough not to be able to do it for a while but I'm sure I'll be eager to get my soon-to-be fat *ss out there as soon as I'm able.

I also more than took JasonF's suggestion on the high zoot wheels, I've got a Parlee Z1x on order, should arrive in a week or so, so I'll have the frame staring at me waiting to get built up while I recover. That'll help get the juices flowing again, I'm sure.

Ginger hit the nail right on the head, most of what's going on is I know I'm going to lose any fitness I gain by riding in this last week and that contributes to the "what's the point" feeling.

Rode 42 miles this morning, enjoyed it very much.

Thanks again all.

[Ginger]

Greg,

Here's a thought that might help you get out on the bike with a bit more enthusiasm. Every surgery I've had (6), and through each PT recovery (PT before the surgery and after) the doctors, anesthesiologists, and physical therapists told me that I was ahead of the curve in recovery because I was active before I went in for surgery.

Another thing to do is to set up your bike on a trainer indoors with a TV/VCR and whatnot now so that when you come out of surgery, you can get on the bike and pedal. No, you can't ride outdoors, but you will be able to keep the legs moving and with focused training you'll keep a lot of your fitness going even though your arm is imobilized. Sure, trainers suck. But you only loose a couple days while recovering from the anesthesia, not weeks and months. (I watched my housemate do this recently with his broken neck...it sucked for him to be in a brace, but he kept his legs and cardio going while he was immobilized.)

Don't look at it as a full stop, just as a different situation. Sort of like winter with heat.
:)

Good luck!
Mary Ann

[gone]

Another thing to do is to set up your bike on a trainer indoors with a TV/VCR and whatnot now so that when you come out of surgery, you can get on the bike and pedal.

Already done.


Don't look at it as a full stop, just as a different situation. Sort of like winter with heat.
:)

Good luck!
Mary Ann
I like your attitude! I'll try hard to adopt it. Thanks again.

[vaxn8r]

Ginger, you nailed it.

Greg, best of luck. One thing I'm sure about, stay positive, that helps a ton.